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Sample records for care pilot study

  1. Connecting Primary Health Care: A Comprehensive Pilot Study

    Directory of Open Access Journals (Sweden)

    Mehran Maghsoudloo

    2016-07-01

    Full Text Available The collection of data within the primary health care facilities in Iran is essentially paper-based. It is focused on family’s health, monitoring of non-infectious and infectious diseases. Clearly due to the paper-based nature of the tasks, timely decision making at most can be difficult if not impossible. As part of an on-going electronic health record implementation project at Tehran University of Medical Sciences, for the first time in the region, based on a comprehensive pilot project, four urban healthcare facilities are connected to their headquarters and beyond, covering all aspects of primary health care, for the last four years. Without delving into the technical aspects of its software engineering processes, the progress of the implementation is reported, selection of summarized data is presented, and experience gained thus far are discussed. Four years passed and if time is any important reason to go by, then it is safe to accept that the software architecture and electronic health record structural model implemented are robust and yet extensible. Aims and duration of a pilot study should be clearly defined prior to start and managed till its completion. Resistance to change and particularly to information technology, apart from its technical aspects, is also based on human factors.

  2. Health Care Delivery Meets Hospitality: A Pilot Study in Radiology.

    Science.gov (United States)

    Steele, Joseph Rodgers; Jones, A Kyle; Clarke, Ryan K; Shoemaker, Stowe

    2015-06-01

    The patient experience has moved to the forefront of health care-delivery research. The University of Texas MD Anderson Cancer Center Department of Diagnostic Radiology began collaborating in 2011 with the University of Houston Conrad N. Hilton College of Hotel and Restaurant Management, and in 2013 with the University of Nevada, Las Vegas, William F. Harrah College of Hotel Administration, to explore the application of service science to improving the patient experience. A collaborative pilot study was undertaken by these 3 institutions to identify and rank the specific needs and expectations of patients undergoing imaging procedures in the MD Anderson Department of Diagnostic Radiology. We first conducted interviews with patients, providers, and staff to identify factors perceived to affect the patient experience. Next, to confirm these factors and determine their relative importance, we surveyed more than 6,000 patients by e-mail. All factors considered important in the interviews were confirmed as important in the surveys. The surveys showed that the most important factors were acknowledgment of the patient's concerns, being treated with respect, and being treated like a person, not a "number"; these factors were more important than privacy, short waiting times, being able to meet with a radiologist, and being approached by a staff member versus having one's name called out in the waiting room. Our work shows that it is possible to identify and rank factors affecting patient satisfaction using techniques employed by the hospitality industry. Such factors can be used to measure and improve the patient experience.

  3. Cost analysis of prenatal care using the activity-based costing model: a pilot study.

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    Gesse, T; Golembeski, S; Potter, J

    1999-01-01

    The cost of prenatal care in a private nurse-midwifery practice was examined using the activity-based costing system. Findings suggest that the activities of the nurse-midwife (the health care provider) constitute the major cost driver of this practice and that the model of care and associated, time-related activities influence the cost. This pilot study information will be used in the development of a comparative study of prenatal care, client education, and self care.

  4. Learning the 'SMART' way... results from a pilot study evaluating an interprofessional acute care study day.

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    Lewis, Robin

    2011-01-01

    A significant number of patients requiring critical care are now being managed outside of critical care facilities. There is evidence that staff looking after these patients lack the necessary knowledge and skills to care for them safely, and that effective pre-registration education can play a significant role in addressing these shortfalls in nurses' knowledge and skills. A team from Sheffield Hallam University, in collaboration with the University of Sheffield, developed a pilot one day interprofessional acute illness programme which was called SMART® (Student Management of Acute illness - Recognition and Treatment). To evaluate the pilot programme, 16 student doctors and 72 student nurses were recruited. A pre- and post-course questionnaire based on the Featherstone et al. (2005) evaluation of ALERT was used to ascertain the students' general level of knowledge of the deteriorating patient, their experiences of and confidence in caring for an acutely unwell patient, and their level of comfort with interprofessional working. The results from the pilot study indicate that the students' levels of knowledge, their levels of confidence and their comfort with interprofessional working all rose after undertaking the programme. The pilot study has a number of implications for the future teaching and learning of acute care clinical skills, within a theoretically based curriculum.

  5. A Pilot Study of Nurses' Experience of Giving Spiritual Care

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    Deal, Belinda

    2010-01-01

    Using spiritual and religious resources gives patients and families strength to cope during a crisis, but nurses often do not offer spiritual care (Kloosterhouse & Ames, 2002). The purpose of this phenomenological study was to explore nurses" lived experience of giving spiritual care. A descriptive phenomenological approach was used to…

  6. Consumer behaviour towards organic, natural and conventional skin care products: a pilot study

    OpenAIRE

    Alina-Aida Drăgan; Dacinia-Crina Petrescu

    2013-01-01

    The aim of this pilot study is to outline consumers’ profile in terms of their interest in organic, natural and conventional skin care, their knowledge about these products and the differences between them, their opinion regarding the performance and price of organic skin care in relation to conventional skin care. The survey used a self-administered questionnaire and was conducted on a sample of 86 customers from Cluj-Napoca, Romania. The results indicate that consumers who pu...

  7. Care-of-Self in Undergraduate Nursing Students: A Pilot Study.

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    Ashcraft, Pamela F; Gatto, Susan L

    2015-01-01

    Poor management of care-of-self behaviors can contribute to job dissatisfaction, burnout, and attrition in nurses. This pilot study, designed to explore self-care among nursing students, was used to examine feasibility for a future long-term study. A descriptive cross-sectional design was used. The data suggest a downward trend of care-of-self behaviors as students assume more responsibility for care of others. Findings substantiate the need for development and implementation of care-of-self-promoting interventions in order to increase lifelong health-promoting behaviors.

  8. Diagnosis of Asthma in Primary Health Care: A Pilot Study

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    Karin C. Ringsberg

    2014-01-01

    Full Text Available Some patients with an asthma diagnosis have a poor controlled asthma. One explanation may be an incorrect diagnosis. Aim. The aim of the study was to diagnose and classify patients with non-infectious lower respiratory tract problems in primary health care using internationally applied diagnostic criteria and diagnostic tests. Patients and Methods. New adult patients visiting a primary health care centre due to lower airway problems were included. The diagnostic tests included FEV1, FVC, PEF, two questionnaires, methacholine test, and skin prick test. Results. The patients (n=43 could be divided into four groups: asthma (28%, asthma-like disorder (44%, idiopathic cough (12%, and a nonreversible bronchial obstructive group (16%. The asthma and asthma-like groups showed similar patterns of airway symptoms and trigger factors, not significantly separated by a special questionnaire. Phlegm, heavy breathing, chest pressure/pain, cough, and wheezing were the most common symptoms. Physical exercise and scents were the dominating trigger factors. Conclusions. Nonobstructive asthma-like symptoms seem to be as common as bronchial asthma in primary health care. Due to the similarities in symptoms and trigger factors the study supports the hypothesis that asthma and nonobstructive asthma-like disorders are integrated in the same “asthma syndrome,” including different mechanisms, not only bronchial obstruction.

  9. Implementing brief cognitive behavioral therapy in primary care: A pilot study.

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    Mignogna, Joseph; Hundt, Natalie E; Kauth, Michael R; Kunik, Mark E; Sorocco, Kristen H; Naik, Aanand D; Stanley, Melinda A; York, Kaki M; Cully, Jeffrey A

    2014-06-01

    Effective implementation strategies are needed to improve the adoption of evidence-based psychotherapy in primary care settings. This study provides pilot data on the test of an implementation strategy conducted as part of a multisite randomized controlled trial examining a brief cognitive-behavioral therapy versus usual care for medically ill patients in primary care, using a hybrid (type II) effectiveness/implementation design. The implementation strategy was multifaceted and included (1) modular-based online clinician training, (2) treatment fidelity auditing with expert feedback, and (3) internal and external facilitation to provide ongoing consultation and support of practice. Outcomes included descriptive and qualitative data on the feasibility and acceptability of the implementation strategy, as well as initial indicators of clinician adoption and treatment fidelity. Results suggest that a comprehensive implementation strategy to improve clinician adoption of a brief cognitive-behavioral therapy in primary care is feasible and effective for reaching high levels of adoption and fidelity.

  10. Brief Intervention Within Primary Care for At-Risk Gambling: A Pilot Study.

    Science.gov (United States)

    Nehlin, Christina; Nyberg, Fred; Jess, Kari

    2016-12-01

    Studies on interventions for at-risk gambling are scarce. This pilot study is the first step in a larger project aimed to develop methods to prevent more serious gambling problems. Drawing on experiences from the alcohol field, the brief intervention (BI) model was tested in a primary care setting. Primary care personnel was trained for 2 days. Patients were screened, and those with signs of problematic gambling were offered a return visit to discuss their gambling habits. Of the 537 screened, 34 (6.3 %) screened positive for problem gambling. Of those, 24 were at-risk gamblers whereof 19 agreed to participate. Six of those 19 took part in a 1-month follow-up. Important information for the planning of upcoming studies was collected from the pilot work. Given that the rate of at-risk gamblers was elevated in this setting we consider primary care a suitable arena for intervention. Staff training and support appeared essential, and questionnaires should be selected that are clear and well-presented so staff feel secure and comfortable with them. The BI model was found to be most suitable for patients already known to the caregiver. The number of participants who were willing to take part in the follow-up was low. To ensure power in future studies, a much larger number of screened patients is evidently necessary.

  11. Assessing emergency medical care in low income countries: A pilot study from Pakistan

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    Akhtar Tasleem

    2008-07-01

    Full Text Available Abstract Background Emergency Medical Care is an important component of health care system. Unfortunately it is however, ignored in many low income countries. We assessed the availability and quality of facility-based emergency medical care in the government health care system at district level in a low income country – Pakistan. Methods We did a quantitative pilot study of a convenience sample of 22 rural and 20 urban health facilities in 2 districts – Faisalabad and Peshawar – in Pakistan. The study consisted of three separate cross-sectional assessments of selected community leaders, health care providers, and health care facilities. Three data collection instruments were created with input from existing models for facility assessment such as those used by the Joint Commission of Accreditation of Hospitals and the National Center for Health Statistics in USA and the Medical Research Council in Pakistan. Results The majority of respondents 43/44(98%, in community survey were not satisfied with the emergency care provided. Most participants 36/44(82% mentioned that they will not call an ambulance in health related emergency because it does not function properly in the government system. The expenses on emergency care for the last experience were reported to be less than 5,000 Pakistani Rupees (equivalent to US$ 83 for 19/29(66% respondents. Most health care providers 43/44(98% were of the opinion that their facilities were inadequately equipped to treat emergencies. The majority of facilities 31/42(74% had no budget allocated for emergency care. A review of medications and equipment available showed that many critical supplies needed in an emergency were not found in these facilities. Conclusion Assessment of emergency care should be part of health systems analysis in Pakistan. Multiple deficiencies in emergency care at the district level in Pakistan were noted in our study. Priority should be given to make emergency care responsive to

  12. Integrating care coordination home telehealth and home based primary care in rural Oklahoma: a pilot study.

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    Sorocco, Kristen H; Bratkovich, Kristi L; Wingo, Rita; Qureshi, Saleem M; Mason, Patrick J

    2013-08-01

    The purpose of this program was to evaluate the benefits of integrating VA Care Coordination Home Telehealth and Telemental health within HBPC. A case study design was used to determine quality assurance and quality improvement of incorporating additional home telehealth equipment within Home Based Primary Care (HBPC). Veterans with complex medical conditions and their caregivers living in rural Oklahoma were enrolled. Veterans received the same care other HBPC patients received with the addition of home telehealth equipment. Members from the interdisciplinary treatment team were certified to use the telehealth equipment. Veterans and their caregivers were trained on use of the equipment in their homes. Standard HBPC program measures were used to assess the program success. Assessments from all disciplines on the HBPC team were at baseline, 3, and 6 months, and participants provided satisfaction and interview data to assess the benefits of integrating technology into standard care delivery within an HBPC program. Six veterans were enrolled (mean age = 72 yrs) with a range of physical health conditions including: chronic obstructive pulmonary disease, cerebrovascular accident, spinal cord injury, diabetes, hypertension, and syncope. Primary mental health conditions included depression, dementia, anxiety, and PTSD. Scores on the Mini-Mental State Examination ranged from 18 to 30. Over a 6-month period, case studies indicated improvements in strength, social functioning, decreased caregiver burden, and compliance with treatment plan. This integration of CCHT and HBPC served previously underserved rural veterans having complex medical conditions and appears both feasible and clinically beneficial to veterans and their caregivers.

  13. A pilot study on early home-based intervention through an intelligent baby gym (CareToy) in preterm infants

    DEFF Research Database (Denmark)

    Sgandurra, Giuseppina; Bartalena, Laura; Cecchi, Francesca

    2016-01-01

    BACKGROUND: CareToy is an intelligent system, inspired by baby gyms, aimed to provide an intensive, individualized, home-based and family-centred early intervention (EI) program. AIMS: A pilot study was carried out to explore the feasibility of CareToy intervention in preterm infants, aged 3-9 mo...

  14. Visit Patterns for Severe Mental Illness with Implementation of Integrated Care: A Pilot Retrospective Cohort Study

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    Meghan Fondow

    2015-12-01

    Full Text Available There is increasing interest in models that integrate behavioral health services into primary care. For patients with severe mental illness (SMI, a population with disproportionate morbidity and mortality, little is known about the impact of such models on primary care clinic utilization, and provider panels. We performed a retrospective cohort pilot study examining visit patterns for 1,105 patients with SMI overall, by provider, before, and after the implementation of a primary care behavioral health model which had a ramp up period from May 2006-August 2007. We used 2003-2012 electronic health record data from two clinics of a Federally Qualified Health Center and conducted interrupted time series and chi-square analyses. During the intervention period there was a significant increase in the proportion of visits per month to the clinic for patient with SMI relative to overall visits (0.27; 95% CI 0.22-0.32. After the intervention period, this rate declined (-0.23; -0.19-0.28 but remained above the pre-intervention period. After integration of behavioral health into our primary care clinics, there was a sharp increase in the number of patients with SMI, suggesting patient willingness to explore receiving care under this model. Clinics looking to adopt the model should be mindful of potential changes in patient subpopulations and proactively manage this transition.

  15. Nutritional status in cognitively intact older people receiving home care services--a pilot study.

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    Soini, H; Routasalo, P; Lagstrom, H

    2005-01-01

    Older adults are a potentially vulnerable group for malnutrition. This cross-sectional pilot study aims to assess the nutritional status of elderly patients living at home and receiving home health care services. The data were collected from patient care plans, the Mini Nutritional Assessment (MNA), and a questionnaire on eating problems. In addition, serum nutritional status indicators were measured, and an oral examination including quantitative saliva measurement was carried out. Out of 71 eligible patients 51 (72%) patients aged 76-93 years participated. MNA results showed that 47% were at risk of malnutrition. Care plans for 26 patients made reference to questions of nutrition but provided no detailed forward planning. The mean serum albumin value was 39.1 +/- 3.8 g/l, seven patients had a value lower than 35 g/l. MNA scores were significantly lower for female patients with haemoglobin values lower than 120 g/l (p = 0.027). The dentist's estimation of dry mouth and subjective problems in energy intake were significantly associated with lower MNA scores (p = 0.049 and p = 0.015). Subjects with functioning natural dentition had higher body mass index (BMI) scores than others (p = 0.0485). The results point at the importance of using screening tools such as the MNA for purposes of nutritional assessment, the estimation of oral problems such as dry mouth, chewing and swallowing problems, and advance planning in nutritional issues within the field of home care.

  16. Generalist care managers for the treatment of depressed medicaid patients in North Carolina: A pilot study

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    Ellis Alan R

    2007-03-01

    Full Text Available Abstract Background In most states, mental illness costs are an increasing share of Medicaid expenditures. Specialized depression care managers (CM have consistently demonstrated improvements in patient outcomes relative to usual primary care (UC, but are costly and may not be fully utilized in smaller practices. A generalist care manager (GCM could manage multiple chronic conditions and be more accepted and cost-effective than the specialist depression CM. We designed a pilot program to demonstrate the feasibility of training/deploying GCMs into primary care settings. Methods We randomized depressed adult Medicaid patients in 2 primary care practices in Western North Carolina to a GCM intervention or to UC. GCMs, already providing services in diabetes and asthma in both study arms, were further trained to provide depression services including self-management, decision support, use of information systems, and care management. The following data were analyzed: baseline, 3- and 6-month Patient Health Questionnaire (PHQ9 scores; baseline and 6-month Short Form (SF 12 scores; Medicaid claims data; questionnaire on patients' perceptions of treatment; GCM case notes; physician and office staff time study; and physician and office staff focus group discussions. Results Forty-five patients were enrolled, the majority with preexisting depression. Both groups improved; the GCM group did not demonstrate better clinical and functional outcomes than the UC group. Patients in the GCM group were more likely to have prescriptions of correct dosing by chart data. GCMs most often addressed comorbid conditions (36%, then social issues (27% and appointment reminders (14%. GCMs recorded an average of 46 interactions per patient in the GCM arm. Focus group data demonstrated that physicians valued using GCMs. A time study documented that staff required no more time interacting with GCMs, whereas physicians spent an average of 4 minutes more per week. Conclusion GCMs

  17. Measuring client experiences in long-term care in the Netherlands: a pilot study with the Consumer Quality Index Long-term Care

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    Kool Rudolf B

    2010-04-01

    Full Text Available Abstract Background This study aims to describe the development, testing and optimization of a new standard instrument, the Consumer Quality Index (CQ-index® Long-term Care, for measuring client experiences with long-term care in the Netherlands. Methods Three versions of the CQ-index questionnaires and protocols for study sampling and data collection were developed, designed for interviews with residents of nursing or residential care homes and postal surveys among representatives of psychogeriatric residents and homecare clients. From July to November 2006 a pilot study was conducted among 2,697 clients of 68 nursing or residential care homes, 2,164 representatives of clients in 57 psychogeriatric care institutions, and 1,462 clients of 19 homecare organizations. We performed psychometric analyses and descriptive analyses, and evaluated the pilot study. Results The pilot study showed the feasibility and usability of the instruments, supported the multidimensionality of the questionnaires and showed first findings on client experiences and possibilities for quality improvement. Nine scales applied to all care settings: shared decision making, attitude and courtesy, information, body care, competence and safety of care, activities, autonomy, mental well-being, and availability of personnel. The pilot resulted in three optimized questionnaires and recommendations for nationwide implementation. Conclusions The CQ-index® Long-term Care provides a good basis to investigate the quality of nursing homes, residential care homes and homecare from the clients' perspective. This standardized instrument enables a nationwide comparison of the quality of long-term care for the purpose of transparency and quality assurance.

  18. Health coaching for glaucoma care: a pilot study using mixed methods

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    Vin A

    2015-10-01

    Full Text Available Anita Vin,1 Suzanne Schneider,2 Kelly W Muir,1,3 Jullia A Rosdahl11Department of Ophthalmology, Duke University, Durham, NC, 2Department of Health Philosophy and Promotion, Maryland University of Integrative Health, Laurel, MD, 3Durham VA Medical Center, Durham, NC, USAIntroduction: Adherence to glaucoma medications is essential for successful treatment of the disease but is complex and difficult for many of our patients. Health coaching has been used successfully in the treatment of other chronic diseases. This pilot study explores the use of health coaching for glaucoma care.Methods: A mixed methods study design was used to assess the health coaching intervention for glaucoma patients. The health coaching intervention consisted of four to six health coaching sessions with a certified health coach via telephone. Quantitative measures included demographic and health information, adherence to glaucoma medications (using the visual analog adherence scale and medication event monitoring system, and an exit survey rating the experience. Qualitative measures included a precoaching health questionnaire, notes made by the coach during the intervention, and an exit interview with the subjects at the end of the study.Results: Four glaucoma patients participated in the study; all derived benefits from the health coaching. Study subjects demonstrated increased glaucoma drop adherence in response to the coaching intervention, in both visual analog scale and medication event monitoring system. Study subjects’ qualitative feedback reflected a perceived improvement in both eye and general health self-care. The subjects stated that they would recommend health coaching to friends or family members.Conclusion: Health coaching was helpful to the glaucoma patients in this study; it has the potential to improve glaucoma care and overall health.Keywords: motivation, behavior change, adherence, medication, health

  19. The treatment of depressed chinese americans using qigong in a health care setting: a pilot study.

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    Yeung, Albert; Slipp, Lauren E; Jacquart, Jolene; Fava, Maurizio; Denninger, John W; Benson, Herbert; Fricchione, Gregory L

    2013-01-01

    Background. This pilot study examined the feasibility and efficacy of providing Qigong treatment in a health center to Chinese Americans with major depressive disorder (MDD). Methods. Fourteen Chinese Americans with MDD were enrolled, and they received a 12-week Qigong intervention. The key outcome measurement was the 17-item Hamilton Rating Scale for Depression (HAM-D17); the Clinical Global Impressions-Severity (CGI-S) and -Improvement (CGI-I), the Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form (Q-LES-Q-SF), and the Multidimensional Scale of Perceived Social Support (MSPSS) were also administered. Positive response was defined as a decrease of 50% or more on the HAM-D17, and remission was defined as HAM-D17 ≤ 7. Patients' outcome measurements were compared before and after the Qigong intervention. Results. Participants (N = 14) were 64% female, with a mean age of 53 (±14). A 71% of participants completed the intervention. The Qigong intervention resulted in a positive treatment-response rate of 60% and a remission rate of 40% and statistically significant improvement, as measured by the HAM-D17, CGI-S, CGI-I, Q-LES-Q-SF, and the family support subscale of the MSPSS. Conclusions. The Qigong intervention provided at a health care setting for the treatment of primary care patients with MDD is feasible. Further studies with larger sample sizes are warranted.

  20. The Treatment of Depressed Chinese Americans Using Qigong in a Health Care Setting: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Albert Yeung

    2013-01-01

    Full Text Available Background. This pilot study examined the feasibility and efficacy of providing Qigong treatment in a health center to Chinese Americans with major depressive disorder (MDD. Methods. Fourteen Chinese Americans with MDD were enrolled, and they received a 12-week Qigong intervention. The key outcome measurement was the 17-item Hamilton Rating Scale for Depression (HAM-D17; the Clinical Global Impressions-Severity (CGI-S and -Improvement (CGI-I, the Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form (Q-LES-Q-SF, and the Multidimensional Scale of Perceived Social Support (MSPSS were also administered. Positive response was defined as a decrease of 50% or more on the HAM-D17, and remission was defined as HAM-D17 ≤ 7. Patients' outcome measurements were compared before and after the Qigong intervention. Results. Participants (N=14 were 64% female, with a mean age of 53 (±14. A 71% of participants completed the intervention. The Qigong intervention resulted in a positive treatment-response rate of 60% and a remission rate of 40% and statistically significant improvement, as measured by the HAM-D17, CGI-S, CGI-I, Q-LES-Q-SF, and the family support subscale of the MSPSS. Conclusions. The Qigong intervention provided at a health care setting for the treatment of primary care patients with MDD is feasible. Further studies with larger sample sizes are warranted.

  1. Un estudio piloto sobre los cuidadores de ancianos. A pilot study on elderly care

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    Alina Alfonso León

    2015-12-01

    Full Text Available A medida que aumenta el nivel de envejecimiento demográfico, crece el interés desde diversas áreas del conocimiento humano de investigar en esta sensible temática. Este trabajo constituye un acercamiento a una importante cuestión que puede ser enmarcada dentro de las relaciones intergeneracionales: el cuidado de las personas mayores, desde el punto de vista de la carga que recae sobre los que ejercen esa tarea. El análisis de un pequeño grupo de entrevistas, arroja luz sobre este tema en la sociedad cubana. Los resultados revelan que los cuidadores cubanos no escapan a los sentimientos de intensa sobrecarga y a las lógicas dudas sobre su capacidad de poder desarrollar a cabalidad esta actividad. Divulgar estos datos pretende promover la realización de estudios de este tipo, a mayor escala. Los mismos deben contribuir a mejorar la calidad de vida de los principales actores de esta actividad: los cuidadores y las personas necesitadas de cuidado. The increase of population ageing is a trigger for the development of scientific studies on that particular matter. This article deals with an important issue: the care of elderly people. The opinion of care providers is taking into account. It is a little pilot study, but it results highlighted feeling and concerns of those people regarding its abilities to conduct this task. The dissemination of the results could help the promotion of wider investigations. The goal is to improve of the quality of life of elderly and care provider.

  2. Implementation of Health Information Technology in Routine Care for Fibromyalgia: Pilot Study.

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    Sparks, Toni; Kawi, Jennifer; Menzel, Nancy Nivison; Hartley, Kendall

    2016-02-01

    Fibromyalgia management remains complicated and challenging. Health information technology is an evidence-based, nonpharmacological self and symptom management strategy, but few studies have evaluated its feasibility for managing fibromyalgia patients in clinical practice. FibroGuide is an example of an evidence-based, interactive, and computer-based program comprised of 10 educational modules on fibromyalgia. Study aims were to: (1) develop a process for implementing FibroGuide into the routine care of patients with fibromyalgia, (2) evaluate the overall impact on fibromyalgia before and after a 12-week implementation, and (3) assess patient perspectives on using FibroGuide health information technology to assist in self-management. In this pilot study, 35 participants with fibromyalgia were recruited from an Advanced Practice Registered Nurse's outpatient clinic. Using a descriptive design, quantitative data analysis was employed to address study aims. Based on data collection pre- and post-intervention using paired samples testing, a statistically significant change (p = .017) was observed in overall fibromyalgia impact (improved symptom severity, activity, and function). Majority felt that FibroGuide was helpful as part of their routine care, and nearly half reported that it assisted in their self-management. Although 65% noted that technology was an effective and efficient way to receive education for fibromyalgia management, 57% preferred talking to healthcare providers. Larger longitudinal studies are needed on the use of health information technology in fibromyalgia, evaluating both statistical and clinical significance, while decreasing barriers to participant use for this promising adjunct to clinical management. Providers need to be well educated on supporting self-management strategies and health information technology.

  3. Oral health champions in long-term care facilities-a pilot study.

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    Amerine, Carol; Boyd, Linda; Bowen, Denise M; Neill, Karen; Johnson, Tara; Peterson, Teri

    2014-01-01

    This preintervention/postintervention pilot study examined impact of onsite support by a dental hygiene champion (DHC) on oral health and quality of life (QOL) of elderly residents in three long-term care facilities (LTCFs) in Arkansas. Oral health and oral health-related QOL were operationalized using the Oral Health Assessment Tool (OHAT) and Geriatric Oral Health Assessment Index (GOHAI), respectively. CNAs in Facility A received standardized oral health education/materials with onsite DHC support. Facility B received education/materials only. Facility C served as control. Data analyses included Wilcoxon-signed rank tests (OHAT) and repeated measures ANOVA (GOHAI) (p ≤ .05). OHAT postintervention data in Facility A showed significant improvements in three measured areas (tongue health, denture status, and oral cleanliness); in Facility B, one area (tongue health); and none in Facility C. No significant differences were found in GOHAI scores across facilities. Findings suggest that the presence of DHCs in LTCFs may positively impact the oral health of CNA-assisted residents.

  4. A pilot study: Reiki for self-care of nurses and healthcare providers.

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    Brathovde, Angela

    2006-01-01

    The purpose of this study was to determine if Reiki energy therapy, level I, was taught as a self-care practice to healthcare providers, would their caring perceptions change? Methodological triangulation technique, including a self-report caring scale and interviews, was used, demonstrating positive changes in perceptions of participants' caring behaviors.

  5. Person-Centered Care in the Home Setting for Parkinson's Disease: Operation House Call Quality of Care Pilot Study.

    Science.gov (United States)

    Hack, Nawaz; Akbar, Umer; Monari, Erin H; Eilers, Amanda; Thompson-Avila, Amanda; Hwynn, Nelson H; Sriram, Ashok; Haq, Ihtsham; Hardwick, Angela; Malaty, Irene A; Okun, Michael S

    2015-01-01

    Objective. (1) To evaluate the feasibility of implementing and evaluating a home visit program for persons with Parkinson's disease (PD) in a rural setting. (2) To have movement disorders fellows coordinate and manage health care delivery. Background. The University of Florida, Center for Movement Disorders and Neurorestoration established Operation House Call to serve patients with PD who could not otherwise afford to travel to an expert center or to pay for medical care. PD is known to lead to significant disability, frequent hospitalization, early nursing home placement, and morbidity. Methods. This was designed as a quality improvement project. Movement disorders fellows travelled to the home(s) of underserved PD patients and coordinated their clinical care. The diagnosis of Parkinson's disease was confirmed using standardized criteria, and the Unified Parkinson's Disease Rating Scale was performed and best treatment practices were delivered. Results. All seven patients have been followed up longitudinally every 3 to 6 months in the home setting, and they remain functional and independent. None of the patients have been hospitalized for PD related complications. Each patient has a new updatable electronic medical record. All Operation House Call cases are presented during video rounds for the interdisciplinary PD team to make recommendations for care (neurology, neurosurgery, neuropsychology, psychiatry, physical therapy, occupational therapy, speech therapy, and social work). One Operation House Call patient has successfully received deep brain stimulation (DBS). Conclusion. This program is a pilot program that has demonstrated that it is possible to provide person-centered care in the home setting for PD patients. This program could provide a proof of concept for the construction of a larger visiting physician or nurse program.

  6. Implementing and optimising an Electronic Library of Health Care in Belgium: results of a pilot study.

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    Hannes, K; Vander Stichele, R H; Simons, E; Geens, S; Goedhuys, J; Aertgeerts, B

    2007-01-01

    Health care practitioners are expected to incorporate results from the best available, scientific information into their daily clinical decision-making process. Useful formats of evidence for practitioners include selected reviews, abstracts in which research results are discussed, "quick answer", evidence-based website including for example diagnostic and therapeutic algorithms, drugs prescription and non-drug therapy. An increasing amount of practitioners has access to the World Wide Web, either at home or at the office. However, easy and cheap access to objective and high quality research results is limited. Many practitioners lack the skills to efficiently navigate complicated medical databases. In 2003 an 'Electronic Library of Health Care' was introduced in Belgium. The main goal of the electronic library is to provide a gateway to scientific evidence to Belgian health care practitioners from different disciplines. This paper presents the results of a pilot project to implement the library in the field. It also describes recent developments and adjustments that increased the efficacy of this gateway to evidence.

  7. The prevalence of uncontrolled pain in long-term care: a pilot study examining outcomes of pain management processes.

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    Good, Heidi; Riley-Doucet, Cheryl K; Dunn, Karen S

    2015-02-01

    Pain in long-term care (LTC) is common among older residents despite the vast options available for optimal pain management. Inadequate pain management affects individual health care outcomes. Researcher evidence has shown that nurse practitioners (NPs) improve the quality of care in LTC but are challenged by multiple barriers that inhibit optimal pain control. The purpose of the current pilot study was to explore both the pain management processes used by nurses in LTC and the documented patient outcomes that come from these processes. In addition, factors were identified that may impact the NP role in providing adequate pain control in LTC. This descriptive study used a retrospective, case-controlled research design that incorporated reviewing 55 LTC resident medical records. Results show how the process of pain management in LTC can be improved by expanding the professional role of the NP.

  8. Chronic illness and multimorbidity among problem drug users: a comparative cross sectional pilot study in primary care.

    LENUS (Irish Health Repository)

    Cullen, Walter

    2012-02-01

    BACKGROUND: Although multimorbidity has important implications for patient care in general practice, limited research has examined chronic illness and health service utilisation among problem drug users. This study aimed to determine chronic illness prevalence and health service utilisation among problem drug users attending primary care for methadone treatment, to compare these rates with matched \\'controls\\' and to develop and pilot test a valid study instrument. METHODS: A cross-sectional study of patients attending three large urban general practices in Dublin, Ireland for methadone treatment was conducted, and this sample was compared with a control group matched by practice, age, gender and General Medical Services (GMS) status. RESULTS: Data were collected on 114 patients. Fifty-seven patients were on methadone treatment, of whom 52(91%) had at least one chronic illness (other then substance use) and 39(68%) were prescribed at least one regular medication. Frequent utilisation of primary care services and secondary care services in the previous six months was observed among patients on methadone treatment and controls, although the former had significantly higher chronic illness prevalence and primary care contact rates. The study instrument facilitated data collection that was feasible and with minimal inter-observer variation. CONCLUSION: Multimorbidity is common among problem drug users attending general practice for methadone treatment. Primary care may therefore have an important role in primary and secondary prevention of chronic illnesses among this population. This study offers a feasible study instrument for further work on this issue. (238 words).

  9. Chronic illness and multimorbidity among problem drug users: a comparative cross sectional pilot study in primary care.

    LENUS (Irish Health Repository)

    Cullen, Walter

    2009-01-01

    BACKGROUND: Although multimorbidity has important implications for patient care in general practice, limited research has examined chronic illness and health service utilisation among problem drug users. This study aimed to determine chronic illness prevalence and health service utilisation among problem drug users attending primary care for methadone treatment, to compare these rates with matched \\'controls\\' and to develop and pilot test a valid study instrument. METHODS: A cross-sectional study of patients attending three large urban general practices in Dublin, Ireland for methadone treatment was conducted, and this sample was compared with a control group matched by practice, age, gender and General Medical Services (GMS) status. RESULTS: Data were collected on 114 patients. Fifty-seven patients were on methadone treatment, of whom 52(91%) had at least one chronic illness (other then substance use) and 39(68%) were prescribed at least one regular medication. Frequent utilisation of primary care services and secondary care services in the previous six months was observed among patients on methadone treatment and controls, although the former had significantly higher chronic illness prevalence and primary care contact rates. The study instrument facilitated data collection that was feasible and with minimal inter-observer variation. CONCLUSION: Multimorbidity is common among problem drug users attending general practice for methadone treatment. Primary care may therefore have an important role in primary and secondary prevention of chronic illnesses among this population. This study offers a feasible study instrument for further work on this issue. (238 words).

  10. Access to specialty care in autism spectrum disorders-a pilot study of referral source

    Directory of Open Access Journals (Sweden)

    West Therese

    2011-05-01

    Full Text Available Abstract Background In the United States, a medical home model has been shown to improve the outcomes for children with special health care needs. As part of this model, primary care physicians provide comprehensive medical care that includes identification of delayed and/or atypical development in children and coordination of care with specialists. However, it is not clear if families of children with Autism Spectrum Disorder (ASD rely on the medical home model for care of their child to the same extent as families of children with other special health care needs. This study aims to add to the understanding of medical care for children with ASD by examining the referral source for specialty care. Methods This retrospective study was accomplished by evaluating parent completed intake data for children with ASD compared to those with other neurological disorders in a single physician Pediatric Neurology Practice at a major urban medical center in Northern New Jersey. To account for referral bias, a similar comparison study was conducted using a multispecialty ASD practice at the same medical center. Parent reported "source of referral" and "reason for the referral" of 189 ASD children and 108 non-ASD neurological disordered children were analyzed. Results The specialty evaluations of ASD were predominantly parent initiated. There were significantly less referrals received from primary care physicians for children with ASD compared to children with other neurodevelopmental disorders. Requirement of an insurance referral was not associated with a primary care physician prompted specialty visit.We identified different patterns of referral to our specialty clinics for children with ASD vs. children with other neurolodevelopmental disorders. Conclusion The majority of the families of children with ASD evaluated at our autism center did not indicate that a primary care physician initiated the specialty referral. This study suggests that families of

  11. An intervention to improve care and reduce costs for high-risk patients with frequent hospital admissions: a pilot study

    Directory of Open Access Journals (Sweden)

    Kostrowski Shannon

    2011-10-01

    Full Text Available Abstract Background A small percentage of high-risk patients accounts for a large proportion of Medicaid spending in the United States, which has become an urgent policy issue. Our objective was to pilot a novel patient-centered intervention for high-risk patients with frequent hospital admissions to determine its potential to improve care and reduce costs. Methods Community and hospital-based care management and coordination intervention with pre-post analysis of health care utilization. We enrolled Medicaid fee-for-service patients aged 18-64 who were admitted to an urban public hospital and identified as being at high risk for hospital readmission by a validated predictive algorithm. Enrolled patients were evaluated using qualitative and quantitative interview techniques to identify needs such as transportation to/advocacy during medical appointments, mental health/substance use treatment, and home visits. A community housing partner initiated housing applications in-hospital for homeless patients. Care managers facilitated appropriate discharge plans then worked closely with patients in the community using a harm reduction approach. Results Nineteen patients were enrolled; all were male, 18/19 were substance users, and 17/19 were homeless. Patients had a total of 64 inpatient admissions in the 12 months before the intervention, versus 40 in the following 12 months, a 37.5% reduction. Most patients (73.3% had fewer inpatient admissions in the year after the intervention compared to the prior year. Overall ED visits also decreased after study enrollment, while outpatient clinic visits increased. Yearly study hospital Medicaid reimbursements fell an average of $16,383 per patient. Conclusions A pilot intervention for high-cost patients shows promising results for health services usage. We are currently expanding our model to serve more patients at additional hospitals to see if the pilot's success can be replicated. Trial registration

  12. Personal Digital Assistants as Point-of-Care Tools in Long-Term Care Facilities: A Pilot Study

    Science.gov (United States)

    Qadri, Syeda S.; Wang, Jia; Ruiz, Jorge G.; Roos, Bernard A.

    2009-01-01

    This study used both survey and interview questionnaires. It was designed to assess the feasibility, usability, and utility of two point-of-care tools especially prepared with information relevant for dementia care by staff nurses in a small, a medium-sized, and a large nursing home in Florida. Twenty-five LPN or RN nurses were recruited for the…

  13. Using touch-screen technology to assess smoking in a low-income primary care clinic: a pilot study.

    Science.gov (United States)

    Smith, Philip H; Homish, Gregory G; Barrick, Christopher; Grier, Nancy L

    2011-01-01

    This pilot study examined the use of a touch-screen tablet personal computer to assess smoking and alcohol use among low-income primary care patients (N = 100) and tested cross-method consistency with a paper assessment. Data were collected in 2009. A touch-screen survey assessed smoking, alcohol use, partner smoking, and acceptability. A separate paper survey assessed smoking, partner smoking, and acceptability. The touch-screen assessment was highly acceptable and reliable. Implications and limitations are noted. Future research should explore the use of touch-screen technology for clinical endeavors requiring a quick assessment of substance use. There was no outside funding for this study.

  14. Cancer treatment, symptom monitoring, and self-care in adults: pilot study.

    Science.gov (United States)

    Williams, Phoebe Dauz; Piamjariyakul, Ubolrat; Ducey, Kathleen; Badura, Jody; Boltz, Kristin D; Olberding, Karmen; Wingate, Anita; Williams, Arthur R

    2006-01-01

    A descriptive study was conducted on self-reported symptoms and self-care by 37 adults receiving chemotherapy primarily for leukemia, lymphomas, or breast cancer or radiation therapy for head and neck or lung cancers. The Therapy-Related Symptom Checklist and demographic and interview forms on self-care for identified symptoms were used. Severe symptoms on the Therapy-Related Symptom Checklist subscales fatigue, eating, nausea, pain, numbness in fingers/toes, hair loss, and constipation were reported by patients on chemotherapy. Those on radiation therapy reported severe symptoms on the eating, fatigue, skin changes, oropharynx, and constipation subscales.Self-care strategies were in the following categories, using complementary medicine as framework: diet/nutrition/lifestyle change (eg, use of nutritional supplements; modifications of food and of eating habits; naps, sleep, and rest); mind/body control (eg, relaxation methods, prayer, music, attending granddaughter's sports events); biologic treatments (vitamins); herbal treatments (green mint tea); and ethnomedicine (lime juice and garlic). The first category was predominantly used by patients in both treatment types. Medications were prescribed also to help control symptoms (eg, pain and nausea). Symptom monitoring and self-care for symptoms identified may be facilitated by the Therapy-Related Symptom Checklist; based on reported symptom severity, care providers may prioritize interventions. A larger study needs to be done on (a) the use of the Therapy-Related Symptom Checklist as a clinical tool to assess symptoms that oncology patients experience during therapy; (b) whether care providers, based on patient-reported symptom severity, can prioritize interventions--and how this influences the efficiency of care; (c) the self-care strategies used by patients on chemotherapy or radiation therapy or both; and (d) how useful these strategies are in alleviating symptoms.

  15. Barriers to obesity management: a pilot study of primary care clinicians

    Science.gov (United States)

    Forman-Hoffman, Valerie; Little, Amanda; Wahls, Terry

    2006-01-01

    Background Obesity is an increasing epidemic in both the US and veteran populations, yet it remains largely understudied in the Veteran's Health Administration (VHA) setting. The purpose of our study was to identify barriers to the effective management of obesity in VHA primary care settings. Methods Three focus groups of clinicians from a Veteran's Affairs Medical Center (VAMC) and an affiliated Community Based Outpatient Center (CBOC) were conducted to identify potential barriers to obesity management. The focus groups and previously published studies then informed the creation of a 47-item survey that was then disseminated and completed by 55 primary care clinicians. Results The focus groups identified provider, system, and patient barriers to obesity care. Lack of obesity training during medical school and residency was associated with lower rates of discussing diet and exercise with obese patients (p < 0.05). Clinicians who watched their own diets vigorously were more likely to calculate BMI for obese patients than other clinicians (42% vs. 13%, p < 0.05). Many barriers identified in previous studies (e.g., attitudes toward obese patients, lack of insurance payments for obesity care) were not prevalent barriers in the current study. Conclusion Many VHA clinicians do not routinely provide weight management services for obese patients. The most prevalent barriers to obesity care were poor education during medical school and residency and the lack of information provided by the VHA to both clinicians and patients about available weight management services. PMID:16756673

  16. Impact of a 2-Day Critical Care Ultrasound Course during Fellowship Training: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Vi Am Dinh

    2015-01-01

    Full Text Available Objectives. Despite the increasing utilization of point-of-care critical care ultrasonography (CCUS, standards establishing competency for its use are lacking. The purpose of this study was to evaluate the effectiveness of a 2-day CCUS course implementation on ultrasound-naïve critical care medicine (CCM fellows. Methods. Prospective evaluation of the impact of a two-day CCUS course on eight CCM fellows’ attitudes, proficiency, and use of CCUS. Ultrasound competency on multiple organ systems was assessed including abdominal, pulmonary, vascular, and cardiac systems. Subjects served as self-controls and were assessed just prior to, within 1 week after, and 3 months after the course. Results. There was a significant improvement in CCM fellows’ written test scores, image acquisition ability, and pathologic image interpretation 1 week after the course and it was retained 3 months after the course. Fellows also had self-reported increased confidence and usage of CCUS applications after the course. Conclusions. Implementation of a 2-day critical care ultrasound course covering general CCUS and basic critical care echocardiography using a combination of didactics, live models, and ultrasound simulators is effective in improving critical care fellows’ proficiency and confidence with ultrasound use in both the short- and long-term settings.

  17. Elder-clowning in long-term dementia care: Results of a pilot study

    Science.gov (United States)

    Kontos, Pia; Miller, Karen-Lee; Colobong, Romeo; Lazgare, Luis Ivan Palma; Binns, Malcolm; Low, Lee-Fay; Surr, Claire; Naglie, Gary

    2016-01-01

    Objectives To assess the effects of elder-clowning on moderate to severe behavioral and psychological symptoms of dementia (BPSD) in nursing home residents with dementia, primarily of the Alzheimer’s type. Design Before-after study. Setting Nursing home. Participants Twenty-three nursing home residents with moderate to severe BPSD defined by the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) score of ≥10, and their care aides. Intervention A pair of elder-clowns visited all residents twice weekly (approximately 10 minutes per visit) for 12 weeks. They utilized improvisation, humor and empathy, as well as expressive modalities such as song, musical instruments, and dance to individualize resident engagement. Measurements Primary outcomes were BPSD measured by the NPI-NH, quality of life measured by Dementia Care Mapping (DCM), and nursing burden of care measured by the Modified Nursing Care Assessment Scale (M-NCAS). Secondary outcomes included occupational disruptiveness measured by the NPI-NH, agitation measured by the Cohen Mansfield Agitation Inventory (CMAI), and psychiatric medication use. Results Over 12 weeks, NPI-NH scores significantly declined (t22 = −2.68, p = 0.01) and DCM quality of life scores significantly improved (F1,50 = 23.09, p clowning reduced moderate to severe BPSD of nursing home residents with dementia, primarily of the Alzheimer’s type. Elder-clowning is a promising intervention that may improve Alzheimer’s dementia care for nursing home residents. PMID:26889843

  18. The Care-Integrated Concentration Meditation Program for Patients With Weaning Difficulty: A Pilot Study.

    Science.gov (United States)

    Thinhuatoey, Benjamard; Songwathana, Praneed; Petpichetchian, Wongchan

    2016-01-01

    Because of the multifaceted process of weaning patients with prolonged mechanical ventilation, enhancing weaning success remains a challenge. The Care-Integrated Concentration Meditation Program was developed on the basis of Buddhist philosophy and implemented to determine its procedural feasibility. A qualitative case study with 3 participants was conducted, and the process and initial outcomes were evaluated.

  19. 30-day hospital readmission of older adults using care transitions after hospitalization: a pilot prospective cohort study

    Directory of Open Access Journals (Sweden)

    Takahashi PY

    2013-06-01

    Full Text Available Paul Y Takahashi,1 Lindsey R Haas,2 Stephanie M Quigg,1 Ivana T Croghan,1 James M Naessens,2 Nilay D Shah,2 Gregory J Hanson11Division of Primary Care Internal Medicine, Department of Medicine, 2Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USAPurpose: Patients leaving the hospital are at increased risk of functional decline and hospital readmission. The Employee and Community Health service at Mayo Clinic in Rochester developed a care transition program (CTP to provide home-based care services for medically complex patients. The study objective was to determine the relationship between CTP use, 30-day hospital readmission, and Emergency Room (ER visits for adults over 60 years with high Elder Risk Assessment scores.Patients and methods: This was a pilot prospective cohort study that included 20 patients that used the CTP and 20 patients discharged from the hospital without using the CTP. The medically complex study patients were drawn from the department of Employee and Community Health population between October 14, 2011 and September 27, 2012. The primary outcomes were 30-day hospital readmission or ER visit after discharge from the hospital. The secondary outcomes were within-group changes in grip strength, gait speed, and quality of life (QOL. Patients underwent two study visits, one at baseline and one at 30 days postbaseline. The primary analysis included time-to-event from baseline to rehospitalization or ER visit. Paired t-tests were used for secondary outcomes, with continuous scores.Results: Of the 40 patients enrolled, 36 completed all study visits. The 30-day hospital readmission rates for usual care patients were 10.5% compared with no readmissions for CTP patients. There were 31.6% ER visits in the UC group and 11.8% in the CTP group (P = 0.37. The secondary analysis showed some improvement in physical QOL scores (pre: 32.7; post: 39.4 for the CTP participants (P < 0.01 and no differences in gait speed or

  20. Barriers to obesity management: a pilot study of primary care clinicians

    Directory of Open Access Journals (Sweden)

    Little Amanda

    2006-06-01

    Full Text Available Background Obesity is an increasing epidemic in both the US and veteran populations, yet it remains largely understudied in the Veteran's Health Administration (VHA setting. The purpose of our study was to identify barriers to the effective management of obesity in VHA primary care settings. Methods Three focus groups of clinicians from a Veteran's Affairs Medical Center (VAMC and an affiliated Community Based Outpatient Center (CBOC were conducted to identify potential barriers to obesity management. The focus groups and previously published studies then informed the creation of a 47-item survey that was then disseminated and completed by 55 primary care clinicians. Results The focus groups identified provider, system, and patient barriers to obesity care. Lack of obesity training during medical school and residency was associated with lower rates of discussing diet and exercise with obese patients (p Conclusion Many VHA clinicians do not routinely provide weight management services for obese patients. The most prevalent barriers to obesity care were poor education during medical school and residency and the lack of information provided by the VHA to both clinicians and patients about available weight management services.

  1. Clinical instructors' knowledge and perceptions about nursing care of older people: a pilot study.

    Science.gov (United States)

    Baumbusch, Jennifer; Dahlke, Sherry; Phinney, Alison

    2014-08-01

    With an aging population, the majority of nurses will spend their careers working with older people. Currently, there is scant research about clinical instructors' knowledge and perceptions about nursing care of older people despite their instrumental role in preparing nurses for practice. The purpose of this study was to explore clinical instructors' knowledge and perceptions about nursing care of older people. A mixed methods approach was used. Fifteen clinical instructors and 15 nurse educators employed on specialized units for older people completed questionnaires. Independent t-tests were administered. Five of the clinical instructors also participated in semi-structured interviews, which were analyzed using thematic analysis. Findings indicated that clinical instructors had significantly lower scores on knowledge and perceptions about nursing care of older people than practice-based nurse educators. Further, clinical instructors found it difficult to integrate specialized knowledge about nursing care of older people along with other aspects of their teaching. They also reported that it was challenging to support learning about best practices for older people within the current clinical context, which was complex and fast-paced. This study reinforces the need for professional development opportunities for clinical instructors to support their instrumental role in preparing students for practice with older people.

  2. Comparison of midwifery care to medical care in hospitals in the Quebec pilot projects study: clinical indicators. L'Equipe dEvaluation des Projets-Pilotes Sages-Femmes.

    Science.gov (United States)

    Fraser, W; Hatem-Asmar, M; Krauss, I; Maillard, F; Bréart, G; Blais, R

    2000-01-01

    The purpose of this study was to compare indicators of process and outcome of midwifery services provided in the Quebec pilot projects to those associated with standard hospital-based medical services. Women receiving each type of care (961 per group) were matched on the basis of socio-demographic characteristics and level of obstetrical risk. We found midwifery care to be associated with less obstetrical intervention and a reduction in selected indicators of maternal morbidity (caesarean section and severe perineal injury). For neonatal outcome indicators, midwifery care was associated with a mixture of benefits and risks: fewer babies with preterm birth and low birthweight, but a trend toward a higher stillbirth ratio and more frequent requirement for neonatal resuscitation. The study design does not permit to conclude that the associations were causal in nature. However, the high stillbirth rate observed in the group of women who were selected for midwife care raises concerns both regarding the appropriateness of the screening procedures for admission to such care and regarding the quality of care itself.

  3. Bedouin-Arab women's access to antenatal care at the interface of physical and structural barriers: A pilot study.

    Science.gov (United States)

    Gottlieb, Nora; Belmaker, Ilana; Bilenko, Natalya; Davidovitch, Nadav

    2011-01-01

    Since 2000, the Israeli Public Health Services have established eight Maternal-and-Child-Health (MCH) stations in unrecognised Bedouin-Arab villages in South Israel in order to reduce barriers to healthcare. The goals of this pilot study were: (1) to explore the new MCH stations' impact on antenatal care (ANC) accessibility; and (2) to compare access to ANC between women from villages with MCH stations and women from villages without MCH stations. The study combined quantitative and qualitative methods including structured interviews with 174 MCH service users, review of 158 ANC records and 16 in-depth interviews with Bedouin-Arab women. The establishment of MCH stations in unrecognised villages has improved physical access to ANC and secondarily diminished other barriers related to financial and sociocultural dimensions of women's access to healthcare, thus enhancing women's options for independent healthcare-seeking; yet, limited opening hours, staff shortages and communication problems hamper ANC delivery at the new MCH stations. This pilot study indicates that the MCH stations' establishment in unrecognised villages was a successful intervention, which improved women's access to ANC. Even though current service delivery challenges need to be overcome to achieve the intervention's full potential, its replication should be considered in further villages.

  4. Barriers to obesity management: a pilot study of primary care clinicians

    OpenAIRE

    2006-01-01

    Background Obesity is an increasing epidemic in both the US and veteran populations, yet it remains largely understudied in the Veteran's Health Administration (VHA) setting. The purpose of our study was to identify barriers to the effective management of obesity in VHA primary care settings. Methods Three focus groups of clinicians from a Veteran's Affairs Medical Center (VAMC) and an affiliated Community Based Outpatient Center (CBOC) were conducted to identify potential barriers to obesit...

  5. Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study.

    Science.gov (United States)

    Mason, Virginia M; Leslie, Gail; Clark, Kathleen; Lyons, Pat; Walke, Erica; Butler, Christina; Griffin, Martha

    2014-01-01

    Preparation for replacing the large proportion of staff nurses reaching retirement age in the next few decades in the United States is essential to continue delivering high-quality nursing care and improving patient outcomes. Retaining experienced critical care nurses is imperative to successfully implementing the orientation of new inexperienced critical care nurses. It is important to understand factors that affect work engagement to develop strategies that enhance nurse retention and improve the quality of patient care. Nurses' experience of moral distress has been measured in medical intensive care units but not in surgical trauma care units, where nurses are exposed to patients and families faced with sudden life-threatening, life-changing patient consequences.This pilot study is a nonexperimental, descriptive, correlational design to examine the effect of compassion satisfaction, compassion fatigue, moral distress, and level of nursing education on critical care nurses' work engagement. This is a partial replication of Lawrence's dissertation. The study also asked nurses to describe sources of moral distress and self-care strategies for coping with stress. This was used to identify qualitative themes about the nurse experiences. Jean Watson's theory of human caring serves as a framework to bring meaning and focus to the nursing-patient caring relationship.A convenience sample of 26 of 34 eligible experienced surgical intensive care unit trauma nurses responded to this survey, indicating a 77% response rate. Twenty-seven percent of the nurses scored high, and 73% scored average on compassion satisfaction. On compassion fatigue, 58% scored average on burnout and 42% scored low. On the secondary traumatic stress subscale, 38% scored average, and 62% scored low. The mean moral distress situations subscale score was 3.4, which is elevated. The mean 9-item Utrecht Work Engagement Scale total score, measuring work engagement, was 3.8, which is considered low

  6. Medical supplies shortages and burnout among greek health care workers during economic crisis: a pilot study.

    Science.gov (United States)

    Rachiotis, George; Kourousis, Christos; Kamilaraki, Maria; Symvoulakis, Emmanouil K; Dounias, George; Hadjichristodoulou, Christos

    2014-01-01

    Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country.

  7. Interprofessional education in primary care for the elderly : a pilot study

    NARCIS (Netherlands)

    Oeseburg, Barth; Hilberts, Rudi; Luten, Truus A.; van Etten, Antoinette V. M.; Slaets, Joris P. J.; Roodbol, Petrie F.

    2013-01-01

    Background: The Dutch health care system faces huge challenges with regard to the demand on elderly care and the competencies of nurses and physicians required to meet this demand. At present, the main focus of health care in the Netherlands lies on illness and treatment. However, (frail) elderly ne

  8. Development of a telemedical monitoring concept for the care of malnourished geriatric home-dwelling patients: a pilot study.

    Science.gov (United States)

    Kraft, Matthias; van den Berg, Neeltje; Kraft, Kathleen; Schmekel, Stefanie; Gärtner, Simone; Krüger, Janine; Meyer, Jens; Lerch, Markus M; Hoffmann, Wolfgang

    2012-06-01

    Elderly patients are at high risk of malnutrition and sarcopenia, promoting further morbidity which in turn decreases quality of life and increases the claiming of medical services and associated costs. Early and sustained administration of oral nutritional supplements has been shown to improve the nutritional status with robust clinical benefit. Many patients however, poorly adhere to prescribed supplements, so consistent monitoring is needed. Clinical monitoring usually ends with the discharge rendering the continuation of nutritional supplement therapy in the patient's home problematic. We developed a telemedicine based health care concept for intensive home monitoring. In a first randomized controlled prospective study we analyzed the feasibility of this innovative approach. The intervention group received oral nutritional supplements and telemedical monitoring with daily assessment of body weight, number of taken oral energy supplements and state of health. The control group received usual care. 13 patients were included in each group, eight patients of the intervention group left the study prematurely, five patients were closely monitored and used the devices for a mean 67 ± 63.5 days. Follow up data of body weight and BMI showed no relevant differences between both groups. The results and experiences gained in this pilot study demonstrate that telemedical systems provide encouraging new options to enable an intensive monitoring of malnourished patients. A continuous intensive therapy monitoring of this patient group however, is a particular challenge. Albeit possibilities, limitations and useful parameters were identified, which will be used to improve the conception in an ongoing prospective randomized trial.

  9. Hands-free image capture, data tagging and transfer using Google Glass: a pilot study for improved wound care management.

    Science.gov (United States)

    Aldaz, Gabriel; Shluzas, Lauren Aquino; Pickham, David; Eris, Ozgur; Sadler, Joel; Joshi, Shantanu; Leifer, Larry

    2015-01-01

    Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing progress over time. Yet, current wound documentation practices using digital photography are often cumbersome and labor intensive. The process of transferring photos into Electronic Medical Records (EMRs) requires many steps and can take several days. Newer smartphone and tablet-based solutions, such as Epic Haiku, have reduced EMR upload time. However, issues still exist involving patient positioning, image-capture technique, and patient identification. In this paper, we present the development and assessment of the SnapCap System for chronic wound photography. Through leveraging the sensor capabilities of Google Glass, SnapCap enables hands-free digital image capture, and the tagging and transfer of images to a patient's EMR. In a pilot study with wound care nurses at Stanford Hospital (n=16), we (i) examined feature preferences for hands-free digital image capture and documentation, and (ii) compared SnapCap to the state of the art in digital wound care photography, the Epic Haiku application. We used the Wilcoxon Signed-ranks test to evaluate differences in mean ranks between preference options. Preferred hands-free navigation features include barcode scanning for patient identification, Z(15) = -3.873, p Haiku, the SnapCap System was preferred for sterile image-capture technique, Z(16) = -3.873, p < 0.001, r = 0.68. Responses were divided with respect to image quality and overall ease of use. The study's results have contributed to the future implementation of new features aimed at enhancing mobile hands-free digital photography for chronic wound care.

  10. Symptom monitoring and dependent care during cancer treatment in children: pilot study.

    Science.gov (United States)

    Williams, Phoebe D; Schmideskamp, Jami; Ridder, E Lavonne; Williams, Arthur R

    2006-01-01

    Symptom monitoring by parents/caregivers of children with cancer and what the caregiver and child did to help alleviate symptoms during chemotherapy were studied. The Therapy-Related Symptom Checklist (TRSC) child version was administered to parents/caregivers of 11 children and adolescents (mean age, 10.4 years; SD, 6.1 years; range, 2-18 years; 45% were boys). The Karnofsky scale was completed by clinicians to rate the child's functional status. The TRSC child version and functional status scores were inversely related. All children experienced nausea; the most frequent symptoms reported were in TRSC subscales: fatigue, nausea, eating, fever, oropharynx, pain, and hair loss. Care strategies that helped were distraction, massage, mouth rinses, and vitamins; some reported that their child received medications for pain, nausea, and vomiting. Using complementary medicine categories, the care strategies were diet/nutrition/lifestyle change (eg, more high-fat, high-calorie foods; new foods; any food the child likes; and much sleep and rest); mind/body control (eg, play, video games, television, reading, activity puzzle, breathing exercises, relaxation methods, and prayer); manual healing method (massage and skin-to-skin contact); and biologic treatments (vitamins). The first 2 categories were the most used. Systematic assessment with a self-report checklist enables the provider to identify and prioritize (according to reported severity) those symptoms needing intervention.

  11. Assessment of Knowledge of Day-Care Center Workers in Basic Aspects of Child Care: A Pilot Study.

    Science.gov (United States)

    1980-06-01

    nineteenth century were patterned upon widespread and successful at- tempts to provide care for children of working mothers in France and England from...due in part to the need to care for and protect children of working mothers and in part to a welfare response which created jobs for unemployed

  12. Evaluation of moral case deliberation at the Dutch Health Care Inspectorate: A pilot study

    NARCIS (Netherlands)

    W. Seekles (Wike); G.A. Widdershoven (Guy); P.B.M. Robben (Paul); G. Van Dalfsen (Gonny); B. Molewijk (Bert)

    2016-01-01

    textabstractBackground: Moral case deliberation (MCD) as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics support on the level of health care regulation, employees of regul

  13. Improving population management through pharmacist-primary care integration: a pilot study.

    Science.gov (United States)

    Kennedy, Amanda G; Chen, Harry; Corriveau, Michele; MacLean, Charles D

    2015-02-01

    Pharmacists have unique skills that may benefit primary care practices. The objective of this demonstration project was to determine the impact of integrating pharmacists into patient-centered medical homes, with a focus on population management. Pharmacists were partnered into 5 primary care practices in Vermont 1 day per week to provide direct patient care, population-based medication management, and prescriber education. The main measures included a description of drug therapy problems identified and cost avoidance models. The pharmacists identified 708 drug therapy problems through direct patient care (336/708; 47.5%), population-based strategies (276/708; 38.9%), and education (96/708; 13.6%). Common population-based strategies included adjusting doses and discontinuing unnecessary medications. Pharmacists' recommendations to correct drug therapy problems were accepted by prescribers 86% of the time, when data about acceptance were known. Of the 49 recommendations not accepted, 47/49 (96%) were population-based and 2/49 (4%) were related to direct patient care. The cost avoidance model suggests $2.11 in cost was avoided for every $1.00 spent on a pharmacist ($373,092/$176,690). There was clear value in integrating pharmacists into primary care teams. Their inclusion prevented adverse drug events, avoided costs, and improved patient outcomes. Primary care providers should consider pharmacists well suited to offer direct patient care, population-based management, and prescriber education to their practices. To be successful, pharmacists must have full permission to document findings in the primary care practices' electronic health records. Given that many pharmacist services do not involve billable activities, sustainability requires identifying alternative funding mechanisms that do not rely on a traditional fee-for-service approach.

  14. Patterns of care and course of symptoms in palliative radiotherapy. A multicenter pilot study analysis

    Energy Technology Data Exchange (ETDEWEB)

    Oorschot, Birgitt van [Wuerzburg Univ. (Germany). Dept. of Radiation Oncology; Schuler, Michael [Wuerzburg Univ. (Germany). Inst. of Psychotherapy and Medical Psychology; Simon, Anke [HELIOS Klinikum Erfurt (Germany). Dept. of Radiation Oncology; Schleicher, Ursula [Center for Radiotherapy, Dueren (Germany); Geinitz, Hans [Technische Univ. Muenchen (Germany). Dept. of Radiotherapy and Radiooncology

    2011-08-15

    To evaluate patterns of care as well as effectiveness and side effects of palliative treatment in four German radiation oncology departments. All referrals in four German radiation oncology departments (two university hospitals, one academic hospital, one private practice) were prospective documented for 1 month in 2008 (2 months at one of the university hospitals). In palliatively irradiated patients, treatment aims and indications as well as treated sites and fractionation schedules were recorded. In addition, symptoms and side effects were analyzed with standardized questionnaires before and at the end of radiotherapy. During the observation period, 603 patients underwent radiation therapy in the four centers and 153 (24%, study popu-lation) were treated with palliative intent. Within the study, patients were most frequently treated for bone (34%) or brain (27%) metastases. 62 patients reported severe or very severe pain, 12 patients reported severe or very severe dyspnea, 27 patients reported neurological deficits or signs of cranial pressure, and 43 patients reported a poor or very poor sense of well-being. The most frequent goals were symptom relief (53%) or prevention of symptoms (46%). Life prolongation was intended in 37% of cases. A wide range of fractionation schedules was applied with total doses ranging from 3-61.2 Gy. Of the patients, 73% received a slightly hypofractionated treatment schedule with doses of > 2.0 Gy to ? 3.0 Gy per fraction and 12% received moderate to highly hypofractionated therapy with doses of > 3.0 Gy to 8.0 Gy. Radiation therapy led to a significant improvement of well-being (35% of patients) and reduction of symptoms, especially with regard to pain (66%), dyspnea (61%), and neurological deficits (60%). Therapy was very well tolerated with only 4.5% grade I or II acute toxicities being observed. Unscheduled termination was observed in 19 patients (12%). Palliative radiation therapy is effective in reducing symptoms, increases

  15. Home Care Service Diversification: A Pilot Investigation.

    Science.gov (United States)

    Jette, Alan M.; And Others

    1981-01-01

    Describes a diversified approach to delivering home care to vulnerable older people. This pilot program, funded by the Massachusetts Department of Elder Affairs, attempted to reduce the demand for scarce homemaker services. Results suggest homecare diversification did not alter consumer satisfaction but increased manager time. (Author/JAC)

  16. A pilot study to determine whether health care professionals perceive stigma in heterozygote carrier identification and disclosure decisions.

    Science.gov (United States)

    Moffett, Alexander; Ross, Lainie Friedman

    2011-08-01

    We conducted an empirical pilot study to assess the attitudes of health care professionals (HCPs) to the personal identification of heterozygote carrier status for two autosomal recessive conditions (cystic fibrosis and a hemoglobinopathy) and for an X-linked disorder (Duchenne muscular dystrophy) using the Health Orientation Scale (HOS) and a modified HIV Stigma Scale. Attitudes towards carrier identification of children were also assessed. Three hundred and ten of 742 (42%) eligible HCPs fully or partly completed the survey. As measured with the HOS and the modified HIV scale, respondents had a more negative reaction to the hypothetical discovery of being a carrier for an autosomal recessive genetic condition that was less likely given their self-identified ancestry. Female respondents had a more negative reaction on both scales to being a carrier for an X-linked disorder than men thought their partners would feel. However, the differences found on the HOS and modified HIV scale are small and their clinical relevance unknown. Fifty-seven percent of respondents agreed that parents should tell their children to keep their carrier status private with many (44%) agreeing that children who learn that they are carriers may suffer from a decrease in self-esteem. The vast majority of respondents would inform immediate family members and HCPs of their carrier status, but would be unlikely to share this information with neighbors or employers. Further study is needed to develop a heterozygote genetic carrier stigma scale.

  17. Hands-free image capture, data tagging and transfer using Google Glass: a pilot study for improved wound care management.

    Directory of Open Access Journals (Sweden)

    Gabriel Aldaz

    Full Text Available Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing progress over time. Yet, current wound documentation practices using digital photography are often cumbersome and labor intensive. The process of transferring photos into Electronic Medical Records (EMRs requires many steps and can take several days. Newer smartphone and tablet-based solutions, such as Epic Haiku, have reduced EMR upload time. However, issues still exist involving patient positioning, image-capture technique, and patient identification. In this paper, we present the development and assessment of the SnapCap System for chronic wound photography. Through leveraging the sensor capabilities of Google Glass, SnapCap enables hands-free digital image capture, and the tagging and transfer of images to a patient's EMR. In a pilot study with wound care nurses at Stanford Hospital (n=16, we (i examined feature preferences for hands-free digital image capture and documentation, and (ii compared SnapCap to the state of the art in digital wound care photography, the Epic Haiku application. We used the Wilcoxon Signed-ranks test to evaluate differences in mean ranks between preference options. Preferred hands-free navigation features include barcode scanning for patient identification, Z(15 = -3.873, p < 0.001, r = 0.71, and double-blinking to take photographs, Z(13 = -3.606, p < 0.001, r = 0.71. In the comparison between SnapCap and Epic Haiku, the SnapCap System was preferred for sterile image-capture technique, Z(16 = -3.873, p < 0.001, r = 0.68. Responses were divided with respect to image quality and overall ease of use. The study's results have contributed to the future implementation of new features aimed at enhancing mobile hands-free digital

  18. The National Single Assessment Tool (SAT) a pilot study in older persons care-survey results.

    Science.gov (United States)

    McDermott-Scales, L; Beaton, D; McMahon, F; Vereker, N; McCormack, B; Coen, R F; O'Keefe, S T

    2013-01-01

    Following a consultation and review process, the interRAI suite of assessment tools was chosen as the most suitable instrument for assessment of the care needs of older people in Ireland. We used previously validated questionnaires to examine the usability, practicality and acceptability of these tools to professionals, carers and clients in rural and urban acute, long-term care and community settings. Of the 45 professionals, 42-44 (93-98%) agreed or strongly agreed with 14 of 15 positive statements regarding the acceptability, clinical value and ease of use of the interRAl tools; 39 (87%) felt the terminology was consistent and familiar, although 35 (78%) felt some areas would require further explanation. Responses from carers (n = 15) and clients (n = 68) were similarly overwhelmingly positive regarding the experience of being assessed using these tools. These results support the clinical utility and practicality of using this approach to assess older people in Irish clinical practice.

  19. Perceptions of glasses as a health care product: a pilot study of New Zealand baby boomers.

    Science.gov (United States)

    Davey, Janet; King, Chloe; Fitzpatrick, Mary

    2012-01-01

    Marketers have been slow to customize their strategies for the influential consumer segment of aging baby boomers. This qualitative research provides insights on New Zealand baby boomers' perceptions of glasses as a health care product. Appearance was a dominant theme; status was not a major concern, although style and fashion were. Wearing glasses had negative associations related to aging; however, both male and female participants recognized that glasses offered improved quality of life. Data relating to the theme of expense indicated that these New Zealand baby boomers made sophisticated perceptual associations and subsequent pragmatic trade-offs between price, quality, and style.

  20. Improving maternity care in the Dominican Republic: a pilot study of a community-based participatory research action plan by an international healthcare team.

    Science.gov (United States)

    Foster, Jennifer; Gossett, Sarah; Burgos, Rosa; Cáceres, Ramona; Tejada, Carmen; Dominguez García, Luis; Ambrosio Rosario, Angel; Almonte, Asela; Perez, Lydia J

    2015-05-01

    This article is a report of the process and results of a feasibility pilot study to improve the quality of maternity care in a sample of 31 women and their newborns delivering in a public, tertiary hospital in the Dominican Republic. The pilot study was the first "action step" taken as a result of a formative, community-based participatory research (CBPR) study conducted between 2008 and 2010 by an interdisciplinary, international partnership of U.S. academic researchers, Dominican medical/nursing personnel, and Dominican community health workers. Health personnel and community health workers separately identified indicators most important to measure quality of antepartum maternity care: laboratory and diagnostic studies and respectful, interpersonal communication. At the midpoint and the completion of data collection, the CBPR team evaluated the change in quality indicators to assess improvement in care. The pilot study supports the idea that joint engagement of community health workers, health personnel, and academic researchers with data creation and patient monitoring is motivating for all to continue to improve services in the cultural context of the Dominican Republic.

  1. Community nurses working in piloted primary care teams: Irish Republic.

    Science.gov (United States)

    Burke, Triona; O'Neill, Catherine

    2010-08-01

    Primary care health services in the Irish Republic have undergone fundamental transformation with the establishment of multidisciplinary primary care teams nationwide. Primary care teams provide a community-based health service delivered through a range of health professionals in an integrated way. As part of this initiative ten pilot teams were established in 2003. This research was undertaken in order to gain an understanding of nurse's experiences of working in a piloted primary care team. The methodology used was a focus group approach. The findings from this study illustrated how community nurse's roles and responsibilities have expanded within the team. The findings also highlighted the benefits and challenges of working as a team with various other community-based health-care disciplines.

  2. Community nurses working in piloted primary care teams: Irish Republic.

    LENUS (Irish Health Repository)

    Burke, Triona

    2010-08-01

    Primary care health services in the Irish Republic have undergone fundamental transformation with the establishment of multidisciplinary primary care teams nationwide. Primary care teams provide a community-based health service delivered through a range of health professionals in an integrated way. As part of this initiative ten pilot teams were established in 2003. This research was undertaken in order to gain an understanding of nurse\\'s experiences of working in a piloted primary care team. The methodology used was a focus group approach. The findings from this study illustrated how community nurse\\'s roles and responsibilities have expanded within the team. The findings also highlighted the benefits and challenges of working as a team with various other community-based health-care disciplines.

  3. Sensory Adapted Dental Environments to Enhance Oral Care for Children with Autism Spectrum Disorders: A Randomized Controlled Pilot Study

    Science.gov (United States)

    Cermak, Sharon A.; Stein Duker, Leah I.; Williams, Marian E.; Dawson, Michael E.; Lane, Christianne J.; Polido, José C.

    2015-01-01

    This pilot and feasibility study examined the impact of a sensory adapted dental environment (SADE) to reduce distress, sensory discomfort, and perception of pain during oral prophylaxis for children with autism spectrum disorder (ASD). Participants were 44 children ages 6-12 (n = 22 typical, n = 22 ASD). In an experimental crossover design, each…

  4. A pilot study on children with limitations in self-care, mobility, and social functions : Effects on family strengths

    NARCIS (Netherlands)

    Pirila, S; van der Meere, J; Seppanen, RL; Korpela, R; Nieminen, P

    2006-01-01

    This pilot study explored the functional skills in 21 young children with activity limitations caused by a variety of brain complications sustained prenatal or perinatal. The Pediatric Evaluation of Disability Inventory (PEDI) was used for this purpose. Scores were correlated with the Family Functio

  5. Case management for at-risk elderly patients in the English integrated care pilots: observational study of staff and patient experience and secondary care utilisation

    Directory of Open Access Journals (Sweden)

    Martin Roland

    2012-07-01

    Full Text Available Introduction: In 2009, the English Department of Health appointed 16 integrated care pilots which aimed to provide better integrated care. We report the quantitative results from a multi-method evaluation of six of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. The interventions focused mainly on delivery system redesign and improved clinical information systems, two key elements of Wagner's Chronic Care Model.Methods: Questionnaires to staff and patients. Difference-in-differences analysis of secondary care utilisation using data on 3,646 patients and 17,311 matched controls, and changes in overall secondary care utilisation.Results: Most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Case management interventions were associated with a 9% increase in emergency admissions. We found some evidence of imbalance between cases and controls which could have biased this estimate, but simulations of the possible effect of unobserved confounders showed that it was very unlikely that the sites achieved their goal of reducing emergency admissions. However, we found significant reductions of 21% and 22% in elective admissions and outpatient attendance in the six months following an intervention, and overall inpatient and outpatient costs were significantly reduced by 9% during this period. Area level analyses of whole practice populations suggested that overall outpatient attendances were significantly reduced by 5% two years after the start of the case management schemes.Conclusion: Case management may result in improvements in some aspects of care and has the potential to reduce secondary care costs. However, to improve

  6. Case management for at-risk elderly patients in the English integrated care pilots: observational study of staff and patient experience and secondary care utilisation

    Directory of Open Access Journals (Sweden)

    Martin Roland

    2012-07-01

    Full Text Available Introduction: In 2009, the English Department of Health appointed 16 integrated care pilots which aimed to provide better integrated care. We report the quantitative results from a multi-method evaluation of six of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. The interventions focused mainly on delivery system redesign and improved clinical information systems, two key elements of Wagner's Chronic Care Model. Methods: Questionnaires to staff and patients. Difference-in-differences analysis of secondary care utilisation using data on 3,646 patients and 17,311 matched controls, and changes in overall secondary care utilisation. Results: Most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Case management interventions were associated with a 9% increase in emergency admissions. We found some evidence of imbalance between cases and controls which could have biased this estimate, but simulations of the possible effect of unobserved confounders showed that it was very unlikely that the sites achieved their goal of reducing emergency admissions. However, we found significant reductions of 21% and 22% in elective admissions and outpatient attendance in the six months following an intervention, and overall inpatient and outpatient costs were significantly reduced by 9% during this period. Area level analyses of whole practice populations suggested that overall outpatient attendances were significantly reduced by 5% two years after the start of the case management schemes. Conclusion: Case management may result in improvements in some aspects of care and has the potential to reduce secondary care costs. However, to improve

  7. A pilot study to explore the feasibility of using theClinical Care Classification System for developing a reliable costing method for nursing services.

    Science.gov (United States)

    Dykes, Patricia C; Wantland, Dean; Whittenburg, Luann; Lipsitz, Stuart; Saba, Virginia K

    2013-01-01

    While nursing activities represent a significant proportion of inpatient care, there are no reliable methods for determining nursing costs based on the actual services provided by the nursing staff. Capture of data to support accurate measurement and reporting on the cost of nursing services is fundamental to effective resource utilization. Adopting standard terminologies that support tracking both the quality and the cost of care could reduce the data entry burden on direct care providers. This pilot study evaluated the feasibility of using a standardized nursing terminology, the Clinical Care Classification System (CCC), for developing a reliable costing method for nursing services. Two different approaches are explored; the Relative Value Unit RVU and the simple cost-to-time methods. We found that the simple cost-to-time method was more accurate and more transparent in its derivation than the RVU method and may support a more consistent and reliable approach for costing nursing services.

  8. Microbial field pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, R.M.; McInerney, M.J.; Menzie, D.E.; Coates, J.D.; Chisholm, J.L.

    1993-05-01

    A multi-well microbially enhanced oil recovery field pilot has been performed in the Southeast Vassar Vertz Sand Unit in Payne County, Oklahoma. The primary emphasis of the experiment was preferential plugging of high permeability zones for the purpose of improving waterflood sweep efficiency. Studies were performed to determine reservoir chemistry, ecology, and indigenous bacteria populations. Growth experiments were used to select a nutrient system compatible with the reservoir that encouraged growth of a group of indigenous nitrate-using bacteria and inhibit growth of sulfate-reducing bacteria. A specific field pilot area behind an active line drive waterflood was selected. Surface facilities were designed and installed. Injection protocols of bulk nutrient materials were prepared to facilitate uniform distribution of nutrients within the pilot area. By the end of December, 1991, 82.5 tons (75.0 tonnes) of nutrients had been injected in the field. A tracer test identified significant heterogeneity in the SEVVSU and made it necessary to monitor additional production wells in the field. The tracer tests and changes in production behavior indicate the additional production wells monitored during the field trial were also affected. Eighty two and one half barrels (13.1 m[sup 3]) of tertiary oil have been recovered. Microbial activity has increased CO[sub 2] content as indicated by increased alkalinity. A temporary rise in sulfide concentration was experienced. These indicate an active microbial community was generated in the field by the nutrient injection. Pilot area interwell pressure interference test results showed that significant permeability reduction occurred. The interwell permeabilities in the pilot area between the injector and the three pilot production wells were made more uniform which indicates a successful preferential plugging enhanced oil recovery project.

  9. A telehealth integrated asthma-COPD service for primary care: a proposal for a pilot feasibility study in Crete, Greece

    Directory of Open Access Journals (Sweden)

    Tzanakis Nikolaos E

    2010-07-01

    Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD and asthma are considered underdiagnosed and misdiagnosed chronic diseases. In The Netherlands, a COPD-asthma telemedicine service has been developed to increase GPs' ability to diagnose and manage COPD and asthma. A telemedicine COPD-asthma service may benefit Greece as it is a country, partly due to its geography, that does not have easy access to pulmonologists. Findings Therefore, a pilot feasibility study has been designed in Greece in order to establish this telemedicine service. Ten rural practices, in the island of Crete, with an average population of 2000 patients per practice will pilot the project supported by three pulmonologists. This paper presents the translated interfaces, the flowcharts and the steps that are considered as necessary for this feasibility study in Crete, Greece.

  10. A telehealth integrated asthma-COPD service for primary care: a proposal for a pilot feasibility study in Crete, Greece

    OpenAIRE

    Tzanakis Nikolaos E; van der Molen Thys; Tsiligianni Ioanna G; Siafakas Nikolaos M; van Heijst Ellen; Lionis Christos

    2010-01-01

    Abstract Background Chronic obstructive pulmonary disease (COPD) and asthma are considered underdiagnosed and misdiagnosed chronic diseases. In The Netherlands, a COPD-asthma telemedicine service has been developed to increase GPs' ability to diagnose and manage COPD and asthma. A telemedicine COPD-asthma service may benefit Greece as it is a country, partly due to its geography, that does not have easy access to pulmonologists. Findings Therefore, a pilot feasibility study has been designed ...

  11. Eccentric exercise versus Usual-care with older cancer survivors: The impact on muscle and mobility- an exploratory pilot study

    Directory of Open Access Journals (Sweden)

    Smith Sheldon B

    2011-01-01

    Full Text Available Abstract Background Resistance exercise programs with high compliance are needed to counter impaired muscle and mobility in older cancer survivors. To date outcomes have focused on older prostate cancer survivors, though more heterogeneous groups of older survivors are in-need. The purpose of this exploratory pilot study is to examine whether resistance exercise via negative eccentrically-induced work (RENEW improves muscle and mobility in a diverse sample of older cancer survivors. Methods A total of 40 individuals (25 female, 15 male with a mean age of 74 (± 6 years who have survived (8.4 ± 8 years since their cancer diagnosis (breast, prostate, colorectal and lymphoma were assigned to a RENEW group or a non-exercise Usual-care group. RENEW was performed for 12 weeks and measures of muscle size, strength, power and mobility were made pre and post training. Results RENEW induced increases in quadriceps lean tissue average cross sectional area (Pre: 43.2 ± 10.8 cm2; Post: 44.9 ± 10.9 cm2, knee extension peak strength (Pre: 248.3 ± 10.8 N; Post: 275.4 ± 10.9 N, leg extension muscle power (Pre: 198.2 ± 74.7 W; Post 255.5 ± 87.3 W, six minute walk distance (Pre: 417.2 ± 127.1 m; Post 466.9 ± 125.1 m and a decrease on the time to safely descend stairs (Pre: 6.8 ± 4.5 s; Post 5.4 ± 2.5 s. A significant (P Conclusions This exploration of RENEW in a heterogeneous cohort of older cancer survivors demonstrates increases in muscle size, strength and power along with improved mobility. The efficacy of a high-force, low perceived exertion exercise suggests RENEW may be suited to older individuals who are survivors of cancer. Trial Registration ClinicalTrials.gov Identifier: NCT00335491

  12. E-assessment of prior learning: a pilot study of interactive assessment of staff with no formal education who are working in Swedish elderly care

    Science.gov (United States)

    2014-01-01

    Background The current paper presents a pilot study of interactive assessment using information and communication technology (ICT) to evaluate the knowledge, skills and abilities of staff with no formal education who are working in Swedish elderly care. Methods Theoretical and practical assessment methods were developed and used with simulated patients and computer-based tests to identify strengths and areas for personal development among staff with no formal education. Results Of the 157 staff with no formal education, 87 began the practical and/or theoretical assessments, and 63 completed both assessments. Several of the staff passed the practical assessments, except the morning hygiene assessment, where several failed. Other areas for staff development, i.e. where several failed (>50%), were the theoretical assessment of the learning objectives: Health, Oral care, Ergonomics, hygiene, esthetic, environmental, Rehabilitation, Assistive technology, Basic healthcare and Laws and organization. None of the staff passed all assessments. Number of years working in elderly care and staff age were not statistically significantly related to the total score of grades on the various learning objectives. Conclusion The interactive assessments were useful in assessing staff members’ practical and theoretical knowledge, skills, and abilities and in identifying areas in need of development. It is important that personnel who lack formal qualifications be clearly identified and given a chance to develop their competence through training, both theoretical and practical. The interactive e-assessment approach analyzed in the present pilot study could serve as a starting point. PMID:24742168

  13. Person-Centered Care in the Home Setting for Parkinson’s Disease: Operation House Call Quality of Care Pilot Study

    Directory of Open Access Journals (Sweden)

    Nawaz Hack

    2015-01-01

    Full Text Available Objective. (1 To evaluate the feasibility of implementing and evaluating a home visit program for persons with Parkinson’s disease (PD in a rural setting. (2 To have movement disorders fellows coordinate and manage health care delivery. Background. The University of Florida, Center for Movement Disorders and Neurorestoration established Operation House Call to serve patients with PD who could not otherwise afford to travel to an expert center or to pay for medical care. PD is known to lead to significant disability, frequent hospitalization, early nursing home placement, and morbidity. Methods. This was designed as a quality improvement project. Movement disorders fellows travelled to the home(s of underserved PD patients and coordinated their clinical care. The diagnosis of Parkinson’s disease was confirmed using standardized criteria, and the Unified Parkinson’s Disease Rating Scale was performed and best treatment practices were delivered. Results. All seven patients have been followed up longitudinally every 3 to 6 months in the home setting, and they remain functional and independent. None of the patients have been hospitalized for PD related complications. Each patient has a new updatable electronic medical record. All Operation House Call cases are presented during video rounds for the interdisciplinary PD team to make recommendations for care (neurology, neurosurgery, neuropsychology, psychiatry, physical therapy, occupational therapy, speech therapy, and social work. One Operation House Call patient has successfully received deep brain stimulation (DBS. Conclusion. This program is a pilot program that has demonstrated that it is possible to provide person-centered care in the home setting for PD patients. This program could provide a proof of concept for the construction of a larger visiting physician or nurse program.

  14. A pilot study to test psychophonetics methodology for self-care and empathy in compassion fatigue, burnout and secondary traumatic stress

    Directory of Open Access Journals (Sweden)

    Katherine J. Train

    2013-01-01

    Full Text Available Background: Home-based care is recognised as being a stressful occupation. Practitioners working with patients experiencing high levels of trauma may be susceptible to compassion fatigue, with the sustained need to remain empathic being a contributing factor.Objectives: The aim of this research was to evaluate psychophonetics methodology for self-care and empathy skills as an intervention for compassion fatigue. Objectives were to measure levels of compassion fatigue pre-intervention, then to apply the intervention and retest levels one month and six months post-intervention.Method: The research applied a pilot test of a developed intervention as a quasi-experiment.The study sample comprised home-based carers working with HIV-positive patients at a hospice in Grabouw, a settlement in the Western Cape facing socioeconomic challenge.Results: The result of the pilot study showed a statistically-significant improvement in secondary traumatic stress, a component of compassion fatigue, measured with the ProQOL v5 instrument post-intervention.Conclusion: The results gave adequate indication for the implementation of a larger study in order to apply and test the intervention. The study highlights a dire need for further research in this field.

  15. The European EUCCLID pilot study on care and complications in an unselected sample of people with type 2 diabetes in primary care

    DEFF Research Database (Denmark)

    Gorter, K.J.; Wens, J.; Khunti, K.;

    2010-01-01

    BACKGROUND: European studies on quality of diabetes care in an unselected primary care diabetes population are scarce. RESEARCH QUESTION: To test the feasibility of the set-up and logistics of a cross-sectional EUropean study on Care and Complications in patients with type 2 diabetes (T2DM....... Besides, 18% were using insulin, 31% had a history of cardiovascular disease, mean HbA1c was 7.1% (range 6.6-8.0), mean systolic blood pressure was 133.7 mmHg (range 126.1-144.4) and mean total cholesterol was 4.9 mmol/l (range 4.0-6.2). CONCLUSION: A European study on care and complications in a random......) in Primary Care (EUCCLID) in 12 European countries. METHOD: One rural and one urban practice from each country participated. The central coordinating centre randomly selected five patients from each practice. Patient characteristics were assessed including medical history, anthropometric measures, quality...

  16. Microbial Field Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, R.M.; McInerney, M.J.; Menzie, D.E.; Chisholm, J.L.

    1990-11-01

    This report covers progress made during the first year of the Microbial Field Pilot Study project. Information on reservoir ecology and characterization, facility and treatment design, core experiments, bacterial mobility, and mathematical modeling are addressed. To facilitate an understanding of the ecology of the target reservoir analyses of the fluids which support bacteriological growth and the microbiology of the reservoir were performed. A preliminary design of facilities for the operation of the field pilot test was prepared. In addition, procedures for facilities installation and for injection treatments are described. The Southeast Vassar Vertz Sand Unit (SEVVSU), the site of the proposed field pilot study, is described physically, historically, and geologically. The fields current status is presented and the ongoing reservoir simulation is discussed. Core flood experiments conducted during the last year were used to help define possible mechanisms involved in microbial enhanced oil recovery. Two possible mechanisms, relative permeability effects and changes in the capillary number, are discussed and related to four Berea core experiments' results. The experiments were conducted at reservoir temperature using SEVVSU oil, brine, and bacteria. The movement and activity of bacteria in porous media were investigated by monitoring the growth of bacteria in sandpack cores under no flow conditions. The rate of bacteria advancement through the cores was determined. A mathematical model of the MEOR process has been developed. The model is a three phase, seven species, one dimensional model. Finite difference methods are used for solution. Advection terms in balance equations are represented with a third- order upwind differencing scheme to reduce numerical dispersion and oscillations. The model is applied to a batch fermentation example. 52 refs., 26 figs., 21 tabs.

  17. Innovation Practice Using Pervasive Mobile Technology Solutions to Improve Population Health Management: A Pilot Study of Gestational Diabetes Patient Care in Australia.

    Science.gov (United States)

    Wickramasinghe, Nilmini; Gururajan, Raj

    2016-01-01

    Healthcare service delivery is moving forward from individual care to population health management, because of the fast growth of health records. However, to improve population health performance, it is necessary to leverage relevant data and information using new technology solutions, such as pervasive diabetes mobile technology solution of Inet International Inc., which offers the potential to facilitate patient empowerment with gestational diabetic care. Hence, this article examines the pilot study outcomes of a small clinical trial focusing on pregnant patients affected by gestational diabetes mellitus, in an Australian not for profit healthcare context. The aims include establishing proof of concept and also assessing the usability, acceptability, and functionality of this mobile solution and thereby generate hypotheses to be tested in a large-scale confirmatory clinical trial.

  18. Liverpool Telecare Pilot: case studies

    Directory of Open Access Journals (Sweden)

    Nigel Barnes

    2006-09-01

    Full Text Available Telecare services use information and communications technology (ICT to support the provision of care to people in their own homes. This paper describes a pilot telecare service employed by Liverpool (UK City Council to support a sample of their frail and elderly social services users. The pilot has been running for over two years and has been deployed for 21 individuals in Liverpool. In this paper we present the pilot system and provide real example cases which help to illustrate the benefits of such a system.

  19. Microbial field pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, R.M.; McInerney, M.J.; Menzie, D.E.; Chisholm, J.L.

    1992-03-01

    The objective of this project is to perform a microbial enhanced oil recovery field pilot in the Southeast Vassar Vertz Sand Unit (SEVVSU) in Payne County, Oklahoma. Indigenous, anaerobic, nitrate reducing bacteria will be stimulated to selectively plug flow paths which have been referentially swept by a prior waterflood. This will force future flood water to invade bypassed regions of the reservoir and increase sweep efficiency. This report covers progress made during the second year, January 1, 1990 to December 31, 1990, of the Microbial Field Pilot Study project. Information on reservoir ecology, surface facilities design, operation of the unit, core experiments, modeling of microbial processes, and reservoir characterization and simulation are presented in the report. To better understand the ecology of the target reservoir, additional analyses of the fluids which support bacteriological growth and the microbiology of the reservoir were performed. The results of the produced and injected water analysis show increasing sulfide concentrations with respect to time. In March of 1990 Mesa Limited Partnership sold their interest in the SEVVSU to Sullivan and Company. In April, Sullivan and Company assumed operation of the field. The facilities for the field operation of the pilot were refined and implementation was begun. Core flood experiments conducted during the last year were used to help define possible mechanisms involved in microbial enhanced oil recovery. The experiments were performed at SEVVSU temperature using fluids and inoculum from the unit. The model described in last year's report was further validated using results from a core flood experiment. The model was able to simulate the results of one of the core flood experiments with good quality.

  20. Microbial field pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, R.M.; McInerney, M.J.; Menzie, D.E.; Chisholm, J.L.

    1992-03-01

    The objective of this project is to perform a microbial enhanced oil recovery field pilot in the Southeast Vassar Vertz Sand Unit (SEVVSU) in Payne County, Oklahoma. Indigenous, anaerobic, nitrate reducing bacteria will be stimulated to selectively plug flow paths which have been referentially swept by a prior waterflood. This will force future flood water to invade bypassed regions of the reservoir and increase sweep efficiency. This report covers progress made during the second year, January 1, 1990 to December 31, 1990, of the Microbial Field Pilot Study project. Information on reservoir ecology, surface facilities design, operation of the unit, core experiments, modeling of microbial processes, and reservoir characterization and simulation are presented in the report. To better understand the ecology of the target reservoir, additional analyses of the fluids which support bacteriological growth and the microbiology of the reservoir were performed. The results of the produced and injected water analysis show increasing sulfide concentrations with respect to time. In March of 1990 Mesa Limited Partnership sold their interest in the SEVVSU to Sullivan and Company. In April, Sullivan and Company assumed operation of the field. The facilities for the field operation of the pilot were refined and implementation was begun. Core flood experiments conducted during the last year were used to help define possible mechanisms involved in microbial enhanced oil recovery. The experiments were performed at SEVVSU temperature using fluids and inoculum from the unit. The model described in last year`s report was further validated using results from a core flood experiment. The model was able to simulate the results of one of the core flood experiments with good quality.

  1. Assessment of oral self-care in patients with periodontitis: a pilot study in a dental school clinic in Japan

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    Masuda Hitomi

    2009-10-01

    Full Text Available Abstract Background Oral hygiene education is central to every stage of periodontal treatment. Successful management of periodontal disease depends on the patient's capacity for oral self-care. In the present study, the oral self-care and perceptions of patients attending a dental school clinic in Japan were assessed using a short questionnaire referring to existing oral health models. Methods A cross-sectional study design was used. The study population consisted of sixty-five patients (age range 23-77 with chronic periodontitis. The pre-tested 19-item questionnaire comprised 3 domains; 1 oral hygiene, 2 dietary habits and 3 perception of oral condition. The questionnaire was used as a part of the comprehensive assessment. Results Analyses of the assessment data revealed no major problems with the respondents' perceived oral hygiene habits, although their actual plaque control levels were not entirely adequate. Most of the respondents acknowledged the importance of prevention of dental caries and periodontal diseases, but less than one third of them were regular users of the dental care system. Twenty-five percent of the respondents were considered to be reluctant to change their daily routines, and 29% had doubts about the impact of their own actions on oral health. Analyzing the relationships between patient responses and oral hygiene status, factors like 'frequency of tooth brushing', 'approximal cleaning', 'dental check-up' and 'compliance with self-care advice' showed statistically significant associations (P Conclusion The clinical utilization of the present questionnaire facilitates the inclusion of multiple aspects of patient information, before initiation of periodontal treatment. The significant associations that were found between some of the self-care behaviors and oral hygiene levels document the important role of patient-centered oral health assessment in periodontal care.

  2. Classroom acoustics: Three pilot studies

    Science.gov (United States)

    Smaldino, Joseph J.

    2005-04-01

    This paper summarizes three related pilot projects designed to focus on the possible effects of classroom acoustics on fine auditory discrimination as it relates to language acquisition, especially English as a second language. The first study investigated the influence of improving the signal-to-noise ratio on the differentiation of English phonemes. The results showed better differentiation with better signal-to-noise ratio. The second studied speech perception in noise by young adults for whom English was a second language. The outcome indicated that the second language learners required a better signal-to-noise ratio to perform equally to the native language participants. The last study surveyed the acoustic conditions of preschool and day care classrooms, wherein first and second language learning occurs. The survey suggested an unfavorable acoustic environment for language learning.

  3. “Partners rather than just providers…”: A qualitative study on health care professionals’ views on implementation of multidisciplinary group meetings in the North West London Integrated Care Pilot

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    Angelos P Kassianos

    2015-09-01

    Full Text Available Introduction: Multidisciplinary group meetings are one of the key drivers of facilitating integrated care. Health care professionals attending such groups have a key role in the success of these discussions and hence, in the forming of multi-professional integrated care. The study aimed to explore the professionals’ experiences and views of participating and implementing the groups in integrated care context. Methods: A qualitative study including 25 semi-structured interviews with professionals participating in the Northwest London Integrated Care Pilot analysed using thematic content analysis. Results: Participants mentioned a number of benefits of participating in the meetings, including shared learning and shared decision-making between different services and specialties. Yet, they perceived barriers that diminish the efficiency of the groups, such as time constraints, group dynamics and technicalities. The participants felt that the quality of discussions and facilitation could be improved, as well as technical arrangements that would make them easier to participate. Most of the participants perceived the groups to be beneficial for providers mostly questioning the benefits for patient care. Conclusion: Findings provide an insight into how health professionals’ views of their participation to the multidisciplinary group meetings can be more effectively translated into more tangible benefits to the patients. To benefit patient care, the multidisciplinary groups need to be more patient-oriented rather than provider-oriented, while overcoming professional boundaries for participating.

  4. Nitrous oxide-oxygen mixture during care of bedsores and painful ulcers in the elderly: a randomized, crossover, open-label pilot study.

    Science.gov (United States)

    Paris, Adeline; Horvath, Rémi; Basset, Pierre; Thiery, Stéphane; Couturier, Pascal; Franco, Alain; Bosson, Jean-Luc

    2008-02-01

    Bedsore and ulcer care can often be painful and no standardized analgesic method exists today for pain relief during treatment in adults and the elderly. To evaluate the analgesic efficacy of a nitrous oxide-oxygen mixture vs. morphine during painful bedsore and ulcer care in adult and elderly patients, we conducted a randomized, crossover, multicenter, prospective, open-label, pilot study. Thirty-four inpatients, aged 53-96 years (median 84 years), were recruited in Grenoble University Hospital, Annecy Hospital and Chambéry Hospital, France, from January to June 2001. Each of the 34 patients received morphine (M), nitrous oxide-oxygen mixture (E), or morphine+nitrous oxide-oxygen mixture (ME) during painful care in a crossover protocol. Treatments were changed every two days and the study duration was six days. Analgesia was evaluated before and after each care session using a behavioral scale to evaluate pain in noncommunicating adults (ECPA), a visual analog scale (VAS), a global hetero-evaluation scale (GHES), and the DOLOPLUS-2 scale. There was a significant overall difference (P<0.01) among the three treatments. On the ECPA, the average difference after and before care was +5.2+/-8.6 (M), -0.3+/-8 (E), and -0.6+/-7.4 (ME), respectively. There was a significant difference between M and E, and M and ME (each P<0.01). No difference was found between E and ME (P=0.97). There were similar significant differences in the GHES and DOLOPLUS-2 scales (all tests P<0.01). Post hoc comparisons showed a significant difference (P<0.01) between M and E, and between M and ME without any additional effect for M+E. No differences were found with regard to safety or tolerability. This pilot study demonstrates the superiority of nitrous oxide-oxygen mixture over morphine for analgesia. This experience suggests that this mixture has ease of use, rapid effect, and limited contraindications when used during painful bedsore and ulcer care in elderly patients. Furthermore, it is well

  5. Total level and release of silver from a nanoparticles containing dressing used in burns care – a pilot study

    OpenAIRE

    Rigo C.; Roman M.; Munivrana I.; Vindigni V.; Azzena B.; Barbante C.; Cairns W. R. L.

    2013-01-01

    For centuries silver and its compounds have been in use to control infection and avoid septicaemia in the care of burns and chronic wounds. Renewed interest has resulted in a number of silver-based dressings exploiting nanotechnology that are now widely employed in burns centers. Despite extensive use, a systematic study of the chemical composition, release kinetics and biochemical action of these products has yet to be published. In this work we have characterized the morphology and elementa...

  6. Improving competencies in evidence-based dementia care: Results from a pilot study on a novel inter-professional training course (the KOMPIDEM project

    Directory of Open Access Journals (Sweden)

    Balzer, Katrin

    2016-04-01

    Full Text Available Objective: In order to address well-known challenges in dementia care, an inter-professional course was developed to improve medical students’ and nursing students’ competencies in the provision of evidence-based care for people with dementia. The course comprises lectures, problem-based learning (PbL tutorials and visitations to care facilities. A pilot study was conducted to evaluate the acceptance and feasibility of the inter-professional course.Methodology: Alongside preliminary implementation of the newly developed course, a pre-post survey was carried out involving all participating students. The questionnaire contained standardized and open-ended questions on participants’ views regarding the quality and relevance of several course components and characteristics. The data were analyzed by means of descriptive statistics.Results: When the course was offered the first time, multiple barriers became evident, leading to premature course termination and subsequent revision of the curriculum. When the revised course was offered, 10 medical students and 8 nursing students participated. The course proved feasible, and the median overall quality was rated as “2” (IQR 2–3 at a rating scale ranging from 1 (very good to 6 (inadequate. Following aspects were most frequently judged positively: the course’s inter-professional scope, the visitations to care facilities and the PbL tutorials. Potential for improvement was particularly noted with regard to a more distinct focus on well-defined, mainly practical learning outcomes. There were no indications of systematic between-group differences in the medical and nursing students’ perceptions of the course program.Conclusions: The results confirmed the feasibility of the inter-professional course on dementia care and the relevance of its inter-professional scope. However, to ensure sustainable course implementation in the long term, further program adaptations based on current findings and

  7. Avaliation between precocious out of bed in the intensive care unit and functionality after discharge: a pilot study

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    Taciana Guterres de Carvalho

    2014-02-01

    Full Text Available Backgound and Objectives: The incidence of complications arising from the deleterious effects of immobility in the intensive care unit contributes to functional decline, increased length of hospital stay and reduced functionality. Physical therapy is able to promote recovery and preservation of functionality, which can minimize these complications - through early mobilization. To evaluate the functionality and independence of patients who underwent a early bed output in the Intensive Care Unit. Methods: A randomized controlled clinical trial was conducted with patients admitted to the Intensive Care Unit (ICU of the Santa Cruz Hospital and having a physiotherapy prescription. The patients were divided into conventional therapy group- control group and intervention group, who performed the protocol of early mobilization, promoting the bed output. The functionality was measured three times (retroactive to hospitalization, at discharge from the ICU and on hospital discharge through the instrument Functional Independence Measure (FIM. Results: Preliminary data indicates that the intervention group (n = 4 presented lower loss of functionality after discharge from the ICU, with a deficit of 19%, having recovered until the hospital discharge 97% of the prehospitalization measure. The control group (n = 5 showed higher loss in the ICU of 47.6%, and was discharged from hospital with only 72% of their basal rate. Conclusion: There was a lower loss rate and better recovery of functionality in the studied population when those were submitted to a systematized and early protocol of mobilization as well as shorter hospital stay.

  8. Evaluation of a Specialized Yoga Program for Persons Admitted to a Complex Continuing Care Hospital: A Pilot Study

    Science.gov (United States)

    Kuluski, Kerry; Bechsgaard, Gitte; Ridgway, Jennifer; Katz, Joel

    2016-01-01

    Introduction. The purpose of this study was to evaluate a specialized yoga intervention for inpatients in a rehabilitation and complex continuing care hospital. Design. Single-cohort repeated measures design. Methods. Participants (N = 10) admitted to a rehabilitation and complex continuing care hospital were recruited to participate in a 50–60 min Hatha Yoga class (modified for wheelchair users/seated position) once a week for eight weeks, with assigned homework practice. Questionnaires on pain (pain, pain interference, and pain catastrophizing), psychological variables (depression, anxiety, and experiences with injustice), mindfulness, self-compassion, and spiritual well-being were collected at three intervals: pre-, mid-, and post-intervention. Results. Repeated measures ANOVAs revealed a significant main effect of time indicating improvements over the course of the yoga program on the (1) anxiety subscale of the Hospital Anxiety and Depression Scale, F(2,18) = 4.74, p Yoga program improves pain-related factors and psychological experiences in individuals admitted to a rehabilitation and complex continuing care hospital. PMID:28115969

  9. Evaluation of a Specialized Yoga Program for Persons Admitted to a Complex Continuing Care Hospital: A Pilot Study

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    Kathryn Curtis

    2016-01-01

    Full Text Available Introduction. The purpose of this study was to evaluate a specialized yoga intervention for inpatients in a rehabilitation and complex continuing care hospital. Design. Single-cohort repeated measures design. Methods. Participants (N=10 admitted to a rehabilitation and complex continuing care hospital were recruited to participate in a 50–60 min Hatha Yoga class (modified for wheelchair users/seated position once a week for eight weeks, with assigned homework practice. Questionnaires on pain (pain, pain interference, and pain catastrophizing, psychological variables (depression, anxiety, and experiences with injustice, mindfulness, self-compassion, and spiritual well-being were collected at three intervals: pre-, mid-, and post-intervention. Results. Repeated measures ANOVAs revealed a significant main effect of time indicating improvements over the course of the yoga program on the (1 anxiety subscale of the Hospital Anxiety and Depression Scale, F(2,18 = 4.74, p<.05, and ηp2 = .35, (2 Self-Compassion Scale-Short Form, F(2,18 = 3.71, p<.05, and ηp2 = .29, and (3 Magnification subscale of the Pain Catastrophizing Scale, F(2,18 = 3. 66, p<.05, and ηp2 = .29. Discussion. The results suggest that an 8-week Hatha Yoga program improves pain-related factors and psychological experiences in individuals admitted to a rehabilitation and complex continuing care hospital.

  10. Facilitated patient experience feedback can improve nursing care: a pilot study for a phase III cluster randomised controlled trial

    Science.gov (United States)

    2013-01-01

    Background England’s extensive NHS patient survey programme has not fulfilled government promises of widespread improvements in patients’ experiences, and media reports of poor nursing care in NHS hospitals are increasingly common. Impediments to the surveys’ impact on the quality of nursing care may include: the fact that they are not ward-specific, so nurses claim “that doesn’t happen on my ward”; nurses’ scepticism about the relevance of patient feedback to their practice; and lack of prompt communication of results. The surveys’ impact could be increased by: conducting ward-specific surveys; returning results to ward staff more quickly; including patients’ written comments in reports; and offering nurses an opportunity to discuss the feedback. Very few randomised trials have been conducted to test the effectiveness of patient feedback on quality improvement and there have been few, if any, published trials of ward-specific patient surveys. Methods Over two years, postal surveys of recent inpatients were conducted at four-monthly intervals in 18 wards in two NHS Trusts in England. Wards were randomly allocated to Basic Feedback (ward-specific printed patient survey results including patients’ written comments sent to nurses by letter); Feedback Plus (in addition to printed results, ward meetings to discuss results and plan improvements) or Control (no active feedback of survey results). Patient survey responses to questions about nursing care were used to compute wards’ average Nursing Care Scores at each interval. Nurses’ reactions to the patient feedback were recorded. Results Conducting ward-level surveys and delivering ward-specific results was feasible. Ward meetings were effective for engaging nurses and challenging scepticism and patients’ written comments stimulated interest. 4,236 (47%) patients returned questionnaires. Nursing Care Scores improved more for Feedback Plus than Basic Feedback or Control (difference between

  11. Poverty Reduction in India through Palliative Care: A Pilot Project

    Science.gov (United States)

    Ratcliff, Cathy; Thyle, Ann; Duomai, Savita; Manak, Manju

    2017-01-01

    Introduction: EMMS International and Emmanuel Hospital Association (EHA) implemented a pilot project, poverty reduction in India through palliative care (PRIPCare). A total of 129 interviews with patients and family enrolled in palliative care at three EHA hospitals (in Fatehpur, Lalitpur and Utraula) and staff discussions established that 66% of palliative care patients had lost livelihoods due to illness, 26% of patients' families had members who had lost livelihoods due to the illness, 98% of enrolled households had debts, 59% had loans for which they had sold assets, 69% of households took out debt after their family member fell ill, many patients do not know about government benefits and lack necessary documents, many village headmen require bribes to give people access to benefits, and many bereaved women and children lose everything. Palliative care enabled 85% of patients and families to spend less on medicines, 31% of patients received free medicines, all patients reduced use of out-patient departments (OPDs), 20% reduced use of inpatient departments (IPDs), and therefore spent less on travel, 8% of patients had started earning again due to improved health, members of 10% of families started earning again, and one hospital educated 171 village headmen and increased by 5% the number of patients and their families receiving government benefits. If only 0.7% of needy adults are receiving palliative care, these benefits could be delivered to 143 times more families, targeted effectively at poverty reduction. Palliative care has great scope to reduce that most desperate poverty in India caused by chronic illness. Context: This article concerns a study by the UK NGO EMMS International and Indian NGO EHA, to assess whether palliative care reduces household poverty. Aims: EHA staff had noticed that many patients spend a lot on ineffective treatment before joining palliative care, many families do not know their entitlement to government healthcare subsidies or

  12. Improving quality of home-based postnatal care by microteaching of multipurpose workers in rural and urban slum areas of Chandigarh, India: a pilot study

    Science.gov (United States)

    Gupta, Madhu; Tripathy, Jaya Prasad; Jamir, Limalemla; Sarwa, Ashutosh; Sinha, Smita; Bhag, Chering

    2017-01-01

    Background Microteaching is an efficient teaching tool to improve skills. Until now, its use is very limited in the health sector. A pilot study was carried out to improve the quality of home-based postnatal care by microteaching of health workers (HWs) and ascertain its feasibility for supportive supervision. Methods All (n=12) the HWs catering to a population of ~0.1 million were video recorded while performing home-based postnatal check up in Chandigarh from August 2013 to December 2014. After each round, HWs were shown their videos and trained in the facility and at home. Video recordings, assessments followed by training, continued until HWs acquired the intended skills. A pretested structured checklist based on the national home-based postnatal care guidelines was used for recording and assessing of postnatal skills. A score “0” given for no task, “1” for incorrectly done or partially done task, and “2” for correct task. The average score of each round was calculated and compared. Results The overall skill assessment score improved from 0.64 to 1.76, newborn examination skill from 0.52 to 1.63, maternal examination from 0.54 to 1.62, and counseling from 1.01 to 1.85 after three rounds of video recording. The proportion of HWs carrying a thermometer increased from 21% to 100%. Second and third rounds of video recording and microteaching were successfully carried out by the program supervisors. Conclusion This was the first study to report on the effective use of microteaching in improving home-based postnatal care skills of the health care workers and its feasibility for supportive supervision. PMID:28031730

  13. Raising awareness of carrier testing for hereditary haemoglobinopathies in high-risk ethnic groups in the Netherlands: a pilot study among the general public and primary care providers

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    Cornel Martina C

    2009-09-01

    Full Text Available Abstract Background In the Netherlands no formal recommendations exist concerning preconceptional or antenatal testing for carriership of hereditary haemoglobinopathies. Those at highest risk may be unaware of the possibility of carrier screening. While universal newborn screening has recently been introduced, neither preconceptional nor antenatal carrier testing is routinely offered by health care services to the general public. A municipal health service and a foundation for public information on medical genetics undertook a pilot project with the aim of increasing knowledge and encouraging informed choice. Two groups were targeted: members of the public from ethnic groups at increased risk, and primary health care providers. This study examines the effectiveness of culturally specific 'infotainment' to inform high-risk ethnic groups about their increased risk for haemoglobinopathies. In addition, the study explores attitudes and intentions of primary care providers towards haemoglobinopathy carrier testing of their patients from high-risk ethnic groups. Methods Informational sessions tailored to the public or professionals were organised in Amsterdam, and evaluated for their effect. Psychological parameters were measured using structured questionnaires based on the Theory of Planned Behaviour. Results The pre-test/post-test questionnaire showed that members of the public gained understanding of inheritance and carriership of haemoglobinopathies from the "infotainment" session (p Conclusion The "infotainment" programme may have a positive effect on people from high-risk groups, but informed general practitioners and midwives were reluctant to facilitate their patients' getting tested. Additional initiatives are needed to motivate primary care providers to facilitate haemoglobinopathy carrier testing for their patients from high-risk backgrounds.

  14. A telemedicine wound care model using 4G with smart phones or smart glasses: A pilot study.

    Science.gov (United States)

    Ye, Junna; Zuo, Yanhai; Xie, Ting; Wu, Minjie; Ni, Pengwen; Kang, Yutian; Yu, Xiaoping; Sun, Xiaofang; Huang, Yao; Lu, Shuliang

    2016-08-01

    To assess the feasibility of a wound care model using 4th-generation mobile communication technology standards (4G) with smart phones or smart glasses for wound management.This wound care model is an interactive, real-time platform for implementing telemedicine changing wound dressings, or doing operations. It was set up in March 2015 between Jinhua in Zhejiang province and Shanghai, China, which are 328 km apart. It comprised of a video application (APP), 4G net, smart phones or smart glasses, and a central server.This model service has been used in 30 patients with wounds on their lower extremities for 109 times in 1 month. Following a short learning curve, the service worked well and was deemed to be user-friendly. Two (6.7%) patients had wounds healed, while others still required wound dressing changes after the study finished. Both local surgeons and patients showed good acceptance of this model (100% and 83.33%, respectively).This telemedicine model is feasible and valuable because it provides an opportunity of medical service about wound healing in remote areas where specialists are scarce.

  15. Assessing clinical support and inter-professional interactions among front-line primary care providers in remote communities in northern Canada: a pilot study

    Directory of Open Access Journals (Sweden)

    Stephanie K. Young

    2016-09-01

    Full Text Available Background: Primary care in remote communities in northern Canada is delivered primarily by nurses who receive clinical support from physicians in regional centres and the patient transportation system. To improve continuity, quality and access to care in remote northern communities, it is important to understand the perspectives of front-line providers and the complex challenges they face. Objective: To design and implement a survey of primary care providers to identify issues relating to inter-professional communication, clinical support and patient evacuation. Methods: In collaboration with the territorial government and regional health authority partners, we developed a 21-item self-administered questionnaire survey, which could be completed online. The survey was sent to 218 physicians and nurses who were employed in the Northwest Territories (NWT at the time of the survey and were involved in sending patients out of the community and/or receiving patients. The survey also contained an open-ended question at the end seeking comments regarding primary health care. Results: The overall low response rate of 39% among nurses and 19% among physicians threatens the validity of the quantitative results. The majority of providers were satisfied with their ability to communicate with other providers in a timely manner, their freedom to make clinical decisions and their overall experience practicing in the NWT. The patient transfer system appears to work from both the sender and receiver perspectives. However, a common theme reported by nurses was that physicians providing clinical advice, especially short-term locums, were not familiar with the local situation, whilst physicians at the receiving end remarked that the clinical information provided to them often lacked clarity. Conclusions: Important lessons were learnt from the pilot study, especially in better engagement of providers in planning and dissemination. The questionnaire design and the

  16. Total level and release of silver from a nanoparticles containing dressing used in burns care – a pilot study

    Directory of Open Access Journals (Sweden)

    Rigo C.

    2013-04-01

    Full Text Available For centuries silver and its compounds have been in use to control infection and avoid septicaemia in the care of burns and chronic wounds. Renewed interest has resulted in a number of silver-based dressings exploiting nanotechnology that are now widely employed in burns centers. Despite extensive use, a systematic study of the chemical composition, release kinetics and biochemical action of these products has yet to be published. In this work we have characterized the morphology and elemental composition of a commercial dressings containing Ag by SEM-EDS. The silver content was determined by ICP-MS to be about 1.4 mg cm-2. Release kinetics in ultra pure water, physiological saline solution and human serum substitute were then deeply investigated. The highest release rates were found in serum substitute, with a maximum of 2.6 μg hr-1 cm-2. Our results show that the mean inhibitory concentrations are exceeded for most common pathogens in serum substitute and sterile water, while the presence of high Cllevels inactivates the dressings.

  17. Pharmaceuticals and personal care products in chicken meat and other food animal products: a market-basket pilot study.

    Science.gov (United States)

    Baron, Patrick A; Love, David C; Nachman, Keeve E

    2014-08-15

    Pharmaceutical drugs are extensively used in industrial food animal production. We examined whether residues of veterinary antibiotics and other pharmaceuticals and personal care products (PPCPs) were detectable in a small market-basket sample of retail chicken (n=39), ground beef (n=3) and milk (n=3) samples. High-performance liquid chromatography and tandem mass spectrometry were used to assess the concentration of 59 PPCPs and their residues in animal products. All samples of ground beef, milk, and 14 chickens were analyzed individually, while an additional 25 chicken samples were pooled and analyzed in groups of five. The majority of PPCPs were not detected in meat and milk samples. Caffeine was detected in two of three milk samples (0.4 ng/mL, 2.0 ng/mL) and in 10 of 19 individual and pooled chicken samples (median: 18.6 ng/g, range: 6.1-28.8 ng/g). Acetaminophen was detected in three of three milk samples (median: 1.5 ng/mL, range: 1.4-2.1 ng/mL). Antibiotics in the tetracycline class were detected in two of three milk samples (median: 1.0 ng/mL, range: 0.1-2.0 ng/mL) and did not exceed regulatory residue tolerances of 300 ng/mL. There are no regulatory residue tolerances for caffeine or acetaminophen in animal products. The acetaminophen detections in milk, however, raise questions about extra-label and unapproved use of pharmaceutical drugs in food animal production, as this drug is not approved for use in lactating dairy cattle or any other type of food animal production. Additional studies are needed to confirm our finding of PPCPs in meat and dairy products.

  18. Paraguayan Education Study: A Pilot Study.

    Science.gov (United States)

    Garcia, Patricia

    A qualitative pilot study, guided by an ecological framework, illustrates the complexities involved in studying the unique linguistic situation in Paraguay between Spanish and the indigenous language of Guarani, and its relationship with education. The pilot study interviewing eight kindergarten children. Seventy five children have been…

  19. A pilot study of comorbidities in patients with Rheumatoid Arthritis at a tertiary care hospital in Northeast India

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    Sukhjinder Singh

    2016-01-01

    Full Text Available On an average, rheumatoid arthritis is associated with one or more comorbid conditions and these comorbidities are associated with various risk factors and medications use in patients with RA. The aim of this study was to assess comorbidities in patients with RA at a tertiary care hospital of Northeast India. This cross sectional study was conducted for 8 months from August 2014 to April 2015. The data was collected from medicine (unit-III outpatient department of Gauhati Medical College and Hospital, Guwahati, Northeast India. Fifty one RA patients were found during study period. Patient's socio-demographic characteristics, comorbidities, risk factors for comorbidities, laboratory investigations, and past and current medications use were collected during their visit to hospital. DAS28 scale was used to assess the disease activity in RA patients. Descriptive statistics were used. Non-normally distributed continuous variables are presented in median and interquartile range. The median age of RA patients was 45(IQR;15. The disease activity was found high (DAS-ESR>5.1 in 34 (66.67% patients. The median DAS28 score was 5.64(IQR;1.44. Majority of the patients with RA were anaemic (n=34, 66.67% followed by infection (n=7, 13.73%, thyroid disease (n=5, 9.80%, renal disease (n=4, 7.84%, osteoporosis (n=3, 5.88%, cardiovascular disease (n=3, 5.88%, lung disease (n=3, 5.88%, and vasculitis (n=1, 1.96%. The commonly reported risk factor was hypertension (19.61% followed by diabetes (n=5, 9.80%, dyslipidemia (n=4, 7.84%, smoking (n=4, 7.84%, family history of CVD (n=2, 3.92%, and alcohol intake (n=1, 1.96%. Among DMARDS, methotrexate (92.16% was the most commonly prescribed drug followed by hydroxychloroquine (74.51% and sulfasalazine (27.45%. Anaemia was the most common comorbid condition found in RA patients. Disease activity was found high in anaemic patients with RA. [Biomed Res Ther 2016; 3(1.000: 454-459

  20. Hands-Free Image Capture, Data Tagging and Transfer Using Google Glass: A Pilot Study for Improved Wound Care Management

    NARCIS (Netherlands)

    Aldaz, G.; Shluzas, L.A.; Pickham, D.; Eris, O.; Sadler, J.; Joshi, S.; Leifer, L.

    2015-01-01

    Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing p

  1. Mindfulness-based stress reduction for GPs: results of a controlled mixed methods pilot study in Dutch primary care

    NARCIS (Netherlands)

    Verweij, H.; Waumans, R.C.; Smeijers, D.; Lucassen, P.L.; Donders, A.R.; Horst, H.E. van der; Speckens, A.E.

    2016-01-01

    BACKGROUND: Burnout is highly prevalent in GPs and can have a negative influence on their wellbeing, performance, and patient care. Mindfulness-based stress reduction (MBSR) may be an effective intervention to decrease burnout symptoms and increase wellbeing. AIM: To gain insight into the feasibilit

  2. Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? A cross sectional pilot feasibility study.

    Directory of Open Access Journals (Sweden)

    Nitika Pant Pai

    Full Text Available BACKGROUND: In South Africa, stigma, discrimination, social visibility and fear of loss of confidentiality impede health facility-based HIV testing. With 50% of adults having ever tested for HIV in their lifetime, private, alternative testing options are urgently needed. Non-invasive, oral self-tests offer a potential for a confidential, unsupervised HIV self-testing option, but global data are limited. METHODS: A pilot cross-sectional study was conducted from January to June 2012 in health care workers based at the University of Cape Town, South Africa. An innovative, unsupervised, self-testing strategy was evaluated for feasibility; defined as completion of self-testing process (i.e., self test conduct, interpretation and linkage. An oral point-of-care HIV test, an Internet and paper-based self-test HIV applications, and mobile phones were synergized to create an unsupervised strategy. Self-tests were additionally confirmed with rapid tests on site and laboratory tests. Of 270 health care workers (18 years and above, of unknown HIV status approached, 251 consented for participation. FINDINGS: Overall, about 91% participants rated a positive experience with the strategy. Of 251 participants, 126 evaluated the Internet and 125 the paper-based application successfully; completion rate of 99.2%. All sero-positives were linked to treatment (completion rate:100% (95% CI, 66.0-100. About half of sero-negatives were offered counselling on mobile phones; completion rate: 44.6% (95% CI, 38.0-51.0. A majority of participants (78.1% were females, aged 18-24 years (61.4%. Nine participants were found sero-positive after confirmatory tests (prevalence 3.6% 95% CI, 1.8-6.9. Six of nine positive self-tests were accurately interpreted; sensitivity: 66.7% (95% CI, 30.9-91.0; specificity:100% (95% CI, 98.1-100. INTERPRETATION: Our unsupervised self-testing strategy was feasible to operationalize in health care workers in South Africa. Linkages were successfully

  3. Efficacy of using physical activity mentors to increase the daily steps of older adults in the primary care setting: a pilot study.

    Science.gov (United States)

    Croteau, Karen A; Suresh, Vijiayurani; Farnham, Elanna

    2014-01-01

    The purpose of this pilot study was to determine if using physical activity (PA) mentors has any additional impact on daily steps of older adults participating in the Maine in Motion (MIM) program in the primary care setting. Participants were randomly assigned to a MIM-only group (n = 14) or a MIM+ mentor group (n = 14). The MIM intervention lasted 6 months with follow-up at 12 months. Average age of participants was 64 ± 8.8 years and most participants had multiple chronic illnesses. At baseline, mean body mass index (BMI) was 32.2 ± 5.1 and average daily steps were 4,236 ± 2,266. Repeated-measures ANOVA revealed significant main effects for steps, F(2.324, 59.104) = 4.168, p = .015, but no main effects for group, F(1, 25) = 2.988, p = .096, or time-by-group interaction, F(2.324, 59.104) = 0.905, p = .151. All participants significantly increased daily steps over the course of the intervention, with MIM+ participants maintaining increases at follow-up. No significant findings were found for BMI.

  4. Dendritic immune cell densities in the central cornea associated with soft contact lens types and lens care solution types: a pilot study

    Directory of Open Access Journals (Sweden)

    Sindt CW

    2012-03-01

    Full Text Available Christine W Sindt1, Trudy K Grout1, D Brice Critser1, Jami R Kern2, David L Meadows21University of Iowa Hospitals and Clinics, Iowa City, IA; 2Alcon Research Ltd, Fort Worth, TX, USABackground: The purpose of this study was to assess whether differences in central corneal dendritic immune cell densities associated with combinations of soft contact lenses and lens care solutions could be detected by in vivo confocal microscopy.Methods: Participants were adults naïve to contact lens wear (n = 10 or who wore soft contact lenses habitually on a daily-wear schedule (n = 38 or on a study-assigned schedule for 30 days with daily disposable silicone hydrogel lenses (n = 15. Central corneas were scanned using an in vivo confocal microscope. Cell densities were compared among groups by demographic parameters, lens materials, and lens care solutions (polyhexamethylene biguanide [PHMB], polyquaternium-1 and myristamidopropyl dimethylamine [PQ/MAPD], peroxide, or blister pack solution [for daily disposable lenses].Results: Among lens wearers, no associations were observed between immune cell densities and age, gender, or years of lens-wearing experience. Mean cell density was significantly lower (P < 0.01 in nonwearers (29 ± 23 cells/mm2, n = 10 than in lens wearers (64 ± 71 cells/mm2, n = 53. Mean cell density was lower (P = 0.21 with traditional polymer lenses (47 ± 44 cells/mm2, n = 12 than with silicone hydrogel lenses (69 ± 77 cells/mm2, n = 41. Lowest to highest mean density of immune cells among lens wearers was as follows: PQ/MAPD solution (49 ± 28 cells/mm2, blister pack solution (63 ± 81 cells/mm2, PHMB solution (66 ± 44 cells/mm2, and peroxide solution (85 ± 112 cells/mm2.Conclusion: In this pilot study, in vivo confocal microscopy was useful for detecting an elevated immune response associated with soft contact lenses, and for identifying lens-related and solution-related immune responses that merit further research.Keywords: Clear Care

  5. Genetically Guided Statin Therapy on Statin Perceptions, Adherence, and Cholesterol Lowering: A Pilot Implementation Study in Primary Care Patients

    Directory of Open Access Journals (Sweden)

    Josephine H. Li

    2014-03-01

    Full Text Available Statin adherence is often limited by side effects. The SLCO1B1*5 variant is a risk factor for statin side effects and exhibits statin-specific effects: highest with simvastatin/atorvastatin and lowest with pravastatin/rosuvastatin. The effects of SLCO1B1*5 genotype guided statin therapy (GGST are unknown. Primary care patients (n = 58 who were nonadherent to statins and their providers received SLCO1B1*5 genotyping and guided recommendations via the electronic medical record (EMR. The primary outcome was the change in Beliefs about Medications Questionnaire, which measured patients’ perceived needs for statins and concerns about adverse effects, measured before and after SLCO1B1*5 results. Concurrent controls (n = 59 were identified through the EMR to compare secondary outcomes: new statin prescriptions, statin utilization, and change in LDL-cholesterol (LDL-c. GGST patients had trends (p = 0.2 towards improved statin necessity and concerns. The largest changes were the “need for statin to prevent sickness” (p < 0.001 and “concern for statin to disrupt life” (p = 0.006. GGST patients had more statin prescriptions (p < 0.001, higher statin use (p < 0.001, and greater decrease in LDL-c (p = 0.059 during follow-up. EMR delivery of SLCO1B1*5 results and recommendations is feasible in the primary care setting. This novel intervention may improve patients’ perceptions of statins and physician behaviors that promote higher statin adherence and lower LDL-c.

  6. Evaluation of a Web-Based E-Learning Platform for Brief Motivational Interviewing by Nurses in Cardiovascular Care: A Pilot Study

    Science.gov (United States)

    Cossette, Sylvie; Heppell, Sonia; Boyer, Louise; Mailhot, Tanya; Simard, Marie-Josée; Tanguay, Jean-Francois

    2016-01-01

    Background Brief motivational interviewing (MI) can contribute to reductions in morbidity and mortality related to coronary artery disease, through health behavior change. Brief MI, unlike more intensive interventions, was proposed to meet the needs of clinicians with little spare time. While the provision of face-to-face brief MI training on a large scale is complicated, Web-based e-learning is promising because of the flexibility it offers. Objective The primary objective of this pilot study was to examine the feasibility and acceptability of a Web-based e-learning platform for brief MI (MOTIV@CŒUR), which was evaluated by nurses in cardiovascular care. The secondary objective was to assess the preliminary effect of the training on nurses’ perceived brief MI skills and self-reported clinical use of brief MI. Methods We conducted a single-group, pre-post pilot study involving nurses working in a coronary care unit to evaluate MOTIV@CŒUR, which is a Web-based e-learning platform for brief MI, consisting of two sessions lasting 30 and 20 minutes. MOTIV@CŒUR covers 4 real-life clinical situations through role-modeling videos showing nurse-client interactions. A brief introduction to MI is followed by role playing, during which a nurse practitioner evaluates clients’ motivation to change and intervenes according to the principles of brief MI. The clinical situations target smoking, medication adherence, physical activity, and diet. Nurses were asked to complete both Web-based training sessions asynchronously within 20 days, which allowed assessment of the feasibility of the intervention. Data regarding acceptability and preliminary effects (perceived skills in brief MI, and self-reported clinical use of conviction and confidence interventions) were self-assessed through Web-based questionnaires 30 days (±5 days) after the first session. Results We enrolled 27 women and 4 men (mean age 37, SD 9 years) in March 2016. Of the 31 participants, 24 (77%, 95% CI 63%

  7. Older adults' attitudes about continuing cancer screening later in life: a pilot study interviewing residents of two continuing care communities

    Directory of Open Access Journals (Sweden)

    Walter Louise C

    2006-08-01

    Full Text Available Abstract Background Individualized decision making has been recommended for cancer screening decisions in older adults. Because older adults' preferences are central to individualized decisions, we assessed older adults' perspectives about continuing cancer screening later in life. Methods Face to face interviews with 116 residents age 70 or over from two long-term care retirement communities. Interview content included questions about whether participants had discussed cancer screening with their physicians since turning age 70, their attitudes about information important for individualized decisions, and their attitudes about continuing cancer screening later in life. Results Forty-nine percent of participants reported that they had an opportunity to discuss cancer screening with their physician since turning age 70; 89% would have preferred to have had these discussions. Sixty-two percent believed their own life expectancy was not important for decision making, and 48% preferred not to discuss life expectancy. Attitudes about continuing cancer screening were favorable. Most participants reported that they would continue screening throughout their lives and 43% would consider getting screened even if their doctors recommended against it. Only 13% thought that they would not live long enough to benefit from cancer screening tests. Factors important to consider stopping include: age, deteriorating or poor health, concerns about the effectiveness of the tests, and doctors recommendations. Conclusion This select group of older adults held positive attitudes about continuing cancer screening later in life, and many may have had unrealistic expectations. Individualized decision making could help clarify how life expectancy affects the potential survival benefits of cancer screening. Future research is needed to determine whether educating older adults about the importance of longevity in screening decisions would be acceptable, affect older adults

  8. Conducting pilot and feasibility studies.

    Science.gov (United States)

    Cope, Diane G

    2015-03-01

    Planning a well-designed research study can be tedious and laborious work. However, this process is critical and ultimately can produce valid, reliable study findings. Designing a large-scale randomized, controlled trial (RCT)-the gold standard in quantitative research-can be even more challenging. Even the most well-planned study potentially can result in issues with research procedures and design, such as recruitment, retention, or methodology. One strategy that may facilitate sound study design is the completion of a pilot or feasibility study prior to the initiation of a larger-scale trial. This article will discuss pilot and feasibility studies, their advantages and disadvantages, and implications for oncology nursing research. 
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  9. Admitting acute ischemic stroke patients to a stroke care monitoring unit versus a conventional stroke unit : a randomized pilot study

    NARCIS (Netherlands)

    Sulter, Geert; Elting, Jan Willem; Langedijk, Marc; Maurits, Natasha M; De Keyser, Jacques

    2003-01-01

    BACKGROUND AND PURPOSE: Pathophysiological considerations and observational studies indicate that elevated body temperature, hypoxia, hypotension, and cardiac arrhythmias in the acute phase of ischemic stroke may aggravate brain damage and worsen outcome. METHODS: Both units were organized with the

  10. A mixed methods pilot study with a cluster randomized control trial to evaluate the impact of a leadership intervention on guideline implementation in home care nursing

    Directory of Open Access Journals (Sweden)

    Tourangeau Ann

    2008-12-01

    Full Text Available Abstract Background Foot ulcers are a significant problem for people with diabetes. Comprehensive assessments of risk factors associated with diabetic foot ulcer are recommended in clinical guidelines to decrease complications such as prolonged healing, gangrene and amputations, and to promote effective management. However, the translation of clinical guidelines into nursing practice remains fragmented and inconsistent, and a recent homecare chart audit showed less than half the recommended risk factors for diabetic foot ulcers were assessed, and peripheral neuropathy (the most significant predictor of complications was not assessed at all. Strong leadership is consistently described as significant to successfully transfer guidelines into practice. Limited research exists however regarding which leadership behaviours facilitate and support implementation in nursing. The purpose of this pilot study is to evaluate the impact of a leadership intervention in community nursing on implementing recommendations from a clinical guideline on the nursing assessment and management of diabetic foot ulcers. Methods Two phase mixed methods design is proposed (ISRCTN 12345678. Phase I: Descriptive qualitative to understand barriers to implementing the guideline recommendations, and to inform the intervention. Phase II: Matched pair cluster randomized controlled trial (n = 4 centers will evaluate differences in outcomes between two implementation strategies. Primary outcome: Nursing assessments of client risk factors, a composite score of 8 items based on Diabetes/Foot Ulcer guideline recommendations. Intervention: In addition to the organization's 'usual' implementation strategy, a 12 week leadership strategy will be offered to managerial and clinical leaders consisting of: a printed materials, b one day interactive workshop to develop a leadership action plan tailored to barriers to support implementation; c three post-workshop teleconferences. Discussion This

  11. Sexuality, pregnancy and midwifery care for women with intellectual disabilities: a pilot study on attitudes of university students.

    Science.gov (United States)

    Jones, Linda K; Binger, Tara E; McKenzie, Christine R; Ramcharan, Paul; Nankervis, Karen

    2010-01-01

    Women with intellectual disability have historically not been provided the opportunity to become mothers. Attitudes held by future professionals will determine the level and quality of support these women are provided. This study was designed to evaluate and compare the attitudes of students from Education, Disability and Midwifery towards the sexuality and parenting of people with an intellectual disability, and to further examine the attitudes held by Midwifery students following a lecture strategy. A questionnaire assessing attitudes towards the sexuality and parenting of people with intellectual disability was implemented and contained the themes of marriage, parenting, sexual intercourse and sterilization. Significant differences were found between student groups on the themes of sterilization and parenting, with further analysis indicating that Disability students held significantly more positive attitudes than the other two groups. Students reported less positive attitudes towards parenting than marriage, sterilization and sexual intercourse. Respondents' age was significantly associated with their attitudes on parenting, indicating that older students held more conservative attitudes towards the ability of people with an intellectual disability to parent. In addition, this research indicated that the attitudes of Midwifery students became more positive following a lecture delivered after the questionnaire.

  12. Integrated care pilot in north west London: a mixed methods evaluation

    Directory of Open Access Journals (Sweden)

    Natasha Curry

    2013-07-01

    Full Text Available Introduction: This paper provides the results of a year-long evaluation of a large-scale integrated care pilot in North West London. The pilot aimed to integrate care across primary, acute, community, mental health and social care for people with diabetes and those over 75 years through: care planning; multidisciplinary case reviews; information sharing; and project management support.   Methods: The evaluation team conducted qualitative studies of change at organisational, clinician, and patient levels (using interviews, focus groups and a survey; and quantitative analysis of change in service use and patient-level clinical outcomes (using patient-level data sets and a matched control study.  Results: The pilot had successfully engaged provider organisations, created a shared strategic vision and established governance structures. However, engagement of clinicians was variable and there was no evidence to date of significant reductions in emergency admissions. There was some evidence of changes in care processes. Conclusion: Although the pilot has demonstrated the beginnings of large-scale change, it remains in the early stages and faces significant challenges as it seeks to become sustainable for the longer term. It is critical that NHS managers and clinicians have realistic expectations of what can be achieved in a relatively short period of time.

  13. Transfer Readiness Pilot Study.

    Science.gov (United States)

    Scott-Skillman, Thelma; And Others

    The California Community Colleges (CCC) has implemented a prototype model for determining student transfer readiness as a primary means of assessing community college transfer effectiveness. This report provides definitions of transfer readiness and guidelines for colleges participating in the CCC transfer readiness study. First, a memorandum from…

  14. 90% Compliance Pilot Studies Final Report

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-06-01

    In early 2010, the U.S. Department of Energy (DOE) announced an opportunity for states to participate in energy code compliance evaluation pilot studies. DOE worked with five Regional Energy Efficiency Organizations (REEOs, formerly referred to as Energy Efficiency Partnerships, or EEPs) to fund pilot studies covering nine states. This report details conclusions stated in individual state reports, as well as conclusions drawn by DOE based on their oversight of the pilot studies, and based on discussions held with the REEOs and representatives from the pilot study states and their contractors.

  15. An interdisciplinary knowledge translation intervention in long-term care: Study protocol for the vitamin D and osteoporosis study (ViDOS pilot cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kennedy Courtney C

    2012-05-01

    Full Text Available Abstract Background Knowledge translation (KT research in long-term care (LTC is still in its early stages. This protocol describes the evaluation of a multifaceted, interdisciplinary KT intervention aimed at integrating evidence-based osteoporosis and fracture prevention strategies into LTC care processes. Methods and design The Vitamin D and Osteoporosis Study (ViDOS is underway in 40 LTC homes (n = 19 intervention, n = 21 control across Ontario, Canada. The primary objectives of this study are to assess the feasibility of delivering the KT intervention, and clinically, to increase the percent of LTC residents prescribed ≥800 IU of vitamin D daily. Eligibility criteria are LTC homes that are serviced by our partner pharmacy provider and have more than one prescribing physician. The target audience within each LTC home is the Professional Advisory Committee (PAC, an interdisciplinary team who meets quarterly. The key elements of the intervention are three interactive educational sessions led by an expert opinion leader, action planning using a quality improvement cycle, audit and feedback reports, nominated internal champions, and reminders/point-of-care tools. Control homes do not receive any intervention, however both intervention and control homes received educational materials as part of the Ontario Osteoporosis Strategy. Primary outcomes are feasibility measures (recruitment, retention, attendance at educational sessions, action plan items identified and initiated, internal champions identified, performance reports provided and reviewed, and vitamin D (≥800 IU/daily prescribing at 6 and 12 months. Secondary outcomes include the proportion of residents prescribed calcium supplements and osteoporosis medications, and falls and fractures. Qualitative methods will examine the experience of the LTC team with the KT intervention. Homes are centrally randomized to intervention and control groups in blocks of variable size using

  16. Early diagnosis and retention in care of HIV-infected patients through rapid salivary testing: a test-and-treat fast track pilot study.

    Science.gov (United States)

    Parisi, Maria Rita; Soldini, Laura; Negri, Silvia; Vidoni, Gian Marino; Gianotti, Nicola; Nozza, Silvia; Schlusnus, Karin; Dorigatti, Fernanda; Lazzarin, Adriano

    2016-01-01

    Aim of this study was to evaluate the efficacy and the retention-in-care of individuals diagnosed during six years of salivary HIV testing (EASY-test project). Among those linked-to-care at the Infectious Diseases Department of San Raffaele Hospital (Milan, Italy), the proportion of patients engaged, retained in care and virologically suppressed after the antiretroviral treatment was 96%, 100% and 95.2%, respectively. Results from our study suggest that salivary HIV testing may help bring to light cases of HIV infection otherwise undiagnosed, and thus favour a more rapid and wider reduction of the HIV infection burden at the population level.

  17. First Breath prenatal smoking cessation pilot study: preliminary findings.

    Science.gov (United States)

    Jehn, Lisette; Lokker, Nicole; Matitz, Debra; Christiansen, Bruce

    2003-01-01

    Despite the many dangers associated with smoking during pregnancy, it remains a salient public health problem for Wisconsin women. The First Breath pilot program was developed in an attempt to reduce rates of smoking during pregnancy among low-income women. Preliminary results suggest that the First Breath counseling-based approach is effective, with a quit rate of 43.8% among First Breath enrollees at 1 month postpartum. Women receiving First Breath cessation counseling also had higher quit rates at every measurement period versus women in a comparison group who were receiving whatever cessation care was available in their county in the absence of First Breath. The First Breath pilot study has demonstrated success in helping pregnant women quit smoking and in creating a model for integration of cessation services into prenatal health care service provision. It is through this success that First Breath is expanding beyond the pilot study stage to a statewide program in 2003.

  18. Telemedicine for urban uninsured: a pilot framework for specialty care planning for sustainability.

    Science.gov (United States)

    Maffei, Roxana; Hudson, Yelena; Dunn, Kim

    2008-11-01

    A national approach to medical care for the uninsured is for the provision of primary and preventive care through Community Health Centers. Access to specialty care for both Medicaid and uninsured patients is in decline even though specialty care has been shown to be cost-effective and improve outcomes. The consequences could result in further deterioration of the health of the uninsured and underinsured populations and increasing costs born by the insured and safety net providers. Telemedicine can provide specialty services efficiently if planned with a business model to sustain the program. This paper outlines a pilot framework to plan and cost-justify telemedicine specialty care for the uninsured and marginally insured. This potential framework is supported by data from an urban community with the highest concentration of uninsured in the country: Houston, Texas. Further study and evaluation will be needed once the framework and tools are implemented to empirically prove the sustainability of telemedicine specialty care for the urban uninsured.

  19. Impact of nursing care in Australian general practice on the quality of care: A pilot of the Patient Enablement and Satisfaction Survey (PESS)

    NARCIS (Netherlands)

    Desborough, J.; Phillips, C.; Banfield, M.; Bagheri, N.; Mills, J.

    2015-01-01

    BACKGROUND: Nursing roles in general practice have undergone significant expansion, but as yet there are few tools to measure the quality of nursing care in general practice. This study piloted the Patient Enablement and Satisfaction Survey (PESS) to evaluate two aspects of quality of care in this s

  20. Antibiotic Prescribing in Primary Care and Antimicrobial Resistance in Patients Admitted to Hospital with Urinary Tract Infection: A Controlled Observational Pilot Study

    Directory of Open Access Journals (Sweden)

    Ceire Costelloe

    2014-01-01

    Full Text Available There is growing evidence that primary care prescribed antibiotics lead to antibiotic resistance in bacteria causing minor infections or being carried by asymptomatic adults, but little research to date has investigated links between primary care prescribed antibiotics and resistance among more serious infections requiring hospital care. Knowledge of these effects is likely to have a major influence on public expectations for, and primary care use of, antibiotics. This study aimed to assess the feasibility of recruiting symptomatic adult patients admitted to hospital with urinary infections and to link primary and secondary data information to investigate the relationship between primary care prescribed antibiotics and antimicrobial resistance in these patients. A microbiology database search of in patients who had submitted a urine sample identified 740 patients who were potentially eligible to take part in the study. Of these, 262 patients did not meet the eligibility criteria, mainly due to use of a urinary catheter (40%. Two-hundred and forty three patients could not be recruited as the nurse was unable to visit the patients prior to discharge, as they were too unwell. Eighty patients provided complete information. Results indicate that there is evidence that prior antibiotic use is associated with resistant infections in hospital patients. A fully powered study, conducted using routinely collected data is proposed to fully clarify the precision of the association.

  1. Attitudes of Bedouin and Jewish Physicians Towards the Medical Care for Persons with Intellectual Disability in the Bedouin Negev Community. A Pilot Study

    Directory of Open Access Journals (Sweden)

    Mohammed Morad

    2004-01-01

    Full Text Available Change in the attitudes of staff or the public towards people with intellectual disability (ID can impact their life and health, but that change has not been studied among physicians who belong to an ethnic minority undergoing dramatic social and economic transition. The goal of this study was to explore the change of attitudes of Negev Bedouin physicians serving their community and their satisfaction with policy, care, and knowledge in the field of ID. Seventeen community physicians (7 Bedouins and 10 Jewish were interviewed using a simple questionnaire that consisted of items measuring attitude and satisfaction. The vast majority of the Bedouin and Jewish physicians had positive attitudes toward inclusion of those in the community with ID and were ready to provide the care needed in the community with special assistance. There was a need for further education in ID and more resources. There was a belief that there is discrimination between the Bedouin and Jewish community in the provision of care to people with ID. General dissatisfaction was expressed about the policy, resources, care provision, and expertise offered to Bedouins with ID. More efforts must be directed to empower the physicians with knowledge, expertise, and resources to handle the care of Bedouins with ID in a culturally appropriate way.

  2. Can adding web-based support to UK primary care exercise referral schemes improve patients’ physical activity levels? Findings from an internal pilot study.

    Directory of Open Access Journals (Sweden)

    Adrian Taylor

    2015-10-01

    Full Text Available Background: Promoting physical activity (PA via primary care exercise referral schemes (ERS is common but there is no rigorous evidence for long term changes in PA (Pavey et al, 2011 among those with chronic conditions. From July 2015, for 15 months, the e-coachER trial began to recruit 1400 patients (in SW England, Birmingham and Glasgow with one or more chronic conditions including diabetes, obesity, hypertension, osteoarthritis, or depression, who are eligible and about to attend an ERS. The two-arm parallel RCT is powered to determine if the addition of a web-based, interactive, theory-driven and evidence-based support system called e-coachER (hosted on the ‘LifeGuide’ platform will result in at least 10% more patients who do 150 mins or more per week of accelerometer assessed moderate or vigorous physical activity (MVPA at 12 months. Recruitment into the trial is within primary care, using both mail-merged patient invitations and opportunistic GP invitations (and exercise referrals. Within the trial, after participants are screened, provide consent and complete baseline assessments, they are randomised to receive usual ERS at each site or usual ERS plus a mailed Welcome Pack with registration details to access e-coachER on-line. Inclusion criteria for entering the trial are: (1 Aged 16-74 years; (2 with one or more of the following: obesity (BMI 30-35, hypertension (SBP 140-179 or DBP 90-109, type 2 diabetes, lower limb osteoarthritis, recent history of treatment for depression; (3 Participants who are in the two lowest (of four groups using the GP Physical Activity Questionnaire; (4 have an e-mail address and access to the internet; (5 Eligible for an ERS. The intervention rationale, design and content are reported in another presentation. Aims: This presentation will provide initial findings from a 3 month internal pilot phase with a focus on trial recruitment and initial intervention engagement. We will present data on the

  3. Understanding the impacts of care farms on health and well-being of disadvantaged populations: a protocol of the Evaluating Community Orders (ECO) pilot study

    NARCIS (Netherlands)

    Elsey, H.; Bragg, R.; Elings, M.; Cade, J.E.; Brennan, C.; Farragher, T.; Tubeuf, S.; Gold, R.; Shickle, D.; Wickramasekera, N.; Richardson, Z.; Murray, J.

    2014-01-01

    Introduction: Care farms, where all or part of the farm is used for therapeutic purposes, show much potential for improving the health and well-being of a range of disadvantaged groups. Studies to date have been qualitative or observational, with limited empirical evidence of the effectiveness of ca

  4. 76 FR 50540 - Pilot Program of Enhanced Contract Care Authority for Veterans in Highly Rural Areas

    Science.gov (United States)

    2011-08-15

    ... AFFAIRS Pilot Program of Enhanced Contract Care Authority for Veterans in Highly Rural Areas AGENCY... implementing Sec. 403 of Public Law (Pub. L.) 110-387, ``Veterans' Mental Health and Other Care Improvements Act of 2008,'' which requires VA to establish a pilot program to contract with non-VA health...

  5. A pet-type robot AIBO-assisted therapy as a day care program for chronic schizophrenia patients: A pilot study

    OpenAIRE

    Shin Narita; Nobuyo Ohtani; Chikako Waga; Mitsuaki Ohta; Jun Ishigooka; Kazuhiko Iwahashi

    2016-01-01

    Background AAT (Animal-assisted therapy) was developed to promote human social and emotional functioning as a day care program for psychiatric patients. Aims In this study, we performed AAT using a pet-type robot, AIBO for schizophrenic patients. Methods After obtaining informed consent, we performed the AIBO-assisted therapy for three schizophrenic (ICD-10, F20.x2) patients (male: 1, female: 2) whose medication did not change over the 8 weeks study period in a ward. Results...

  6. Child voice and noise: a pilot study of noise in day cares and the effects on 10 children's voice quality according to perceptual evaluation.

    Science.gov (United States)

    McAllister, Anita M; Granqvist, Svante; Sjölander, Peta; Sundberg, Johan

    2009-09-01

    The purpose of this investigation was to study children's exposure to background noise at the ears during a normal day at the day care center and also to relate this to a perceptual evaluation of voice quality. Ten children, from three day care centers, with no history of hearing and speech problems or frequent infections were selected as subjects. A binaural recording technique was used with two microphones placed on both sides of the subject's head, at equal distance from the mouth. A portable digital audio tape (DAT) recorder (Sony TCD-D 100, Stockholm, Sweden) was attached to the subject's waist. Three recordings were made for each child during the day. Each recording was calibrated and started with three repetitions of three sentences containing only sonorants. The recording technique allowed separate analyses of the background noise level and of the sound pressure level (SPL) of each subjects' own voice. Results showed a mean background noise level for the three day care centers at 82.6dBA Leq, ranging from 81.5 to 83.6dBA Leq. Day care center no. 2 had the highest mean value and also the highest value at any separate recording session with a mean background noise level of 85.4dBA Leq during the noontime recordings. Perceptual evaluation showed that the children attending this day care center also received higher values on the following voice characteristics: hoarseness, breathiness, and hyperfunction. Girls increased their loudness level during the day, whereas for boys no such change could be observed.

  7. Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers’ Perspectives on Testing, Training and Quality Assurance

    Science.gov (United States)

    Ansbro, Éimhín M.; Gill, Michelle M.; Reynolds, Joanna; Shelley, Katharine D.; Strasser, Susan; Sripipatana, Tabitha; Ncube, Alexander Tshaka; Tembo Mumba, Grace; Terris-Prestholt, Fern; Peeling, Rosanna W.; Mabey, David

    2015-01-01

    Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST) allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW) acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH) adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We illustrate that new

  8. Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance.

    Directory of Open Access Journals (Sweden)

    Éimhín M Ansbro

    Full Text Available Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We

  9. [How are Pediatric Hospitals in North-Rhine Westfalia Prepared to Overcome Language Barriers? A Pilot Study Exploring The Structural Quality of Inpatient Care].

    Science.gov (United States)

    Langer, T; Zapf, T; Wirth, S; Meyer, B; Wiegand, A; Timmen, H; Gupta, S J; Schuster, S; Geraedts, M

    2016-05-04

    Background: In Germany, 35% of all children are considered to have a "migration background", and in the state of North-Rhine-Westfalia 43%. Frequently, one or both parents of a patient with a migration background have limited German language proficiency. Communication barriers due to a language difference can have a negative impact on quality of care, patient safety and costs of care. In this study, we investigate how children's hospitals are prepared to meet the challenges associated with language barriers. Methods: We surveyed all children's hospitals in the state of North-Rhine-Westfalia, Germany. The questionnaire was based on the "Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS)" and was adapted to circumstances in Germany. Results: Thirty-eight hospitals participated (51%) in this survey. Language barriers occurred frequently (75% of respondents mentioned language difficulties in more than 10% of the patient population). 82% of respondents rated their hospital to be "less than well prepared" to overcome language barriers. In the majority of hospitals (62%), the need for an interpreter was determined on a case-to-case basis and not according to any set protocol. In most cases bilingual staff was used for interpreting. However, only 38% of respondents found a list of available bilingual staff to be a sufficient resource. 42% of respondents did not know the monthly costs for professional interpreting services. In the remaining cases, costs were less than € 500/month. Conclusion: To overcome language barriers, hospitals rely on local resources. The majority of respondents did not find them to be appropriate and sufficient. The development of quality standards and the provision of financial resources are necessary to mobilize this potential for improvement. Therefore, other disciplines and sectors of healthcare need to be analyzed in order to provide the evidence for a constructive discussion with decision

  10. Barriers and facilitators to integrating care: experiences from the English Integrated Care Pilots

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    Tom Ling

    2012-07-01

    Full Text Available Background. In 2008, the English Department of Health appointed 16 'Integrated Care Pilots' which used a range of approaches to provide better integrated care. We report qualitative analyses from a three year multi-method evaluation to identify barriers and facilitators to successful integration of care.  Theory and methods. Data were analysed from transcripts of 213 in-depth staff interviews, and from semi-structured questionnaires (the 'Living Document' completed by staff in pilot sites at six points over a two-year period. Emerging findings were therefore built from 'bottom up' and grounded in the data. However, we were then interested in how these findings compared and contrasted with more generic analyses. Therefore after our analyses were complete we then systematically compared and contrasted the findings with the analysis of barriers and facilitators to quality improvement identified in a systematic review by Kaplan et al (2010 and the analysis of more micro-level shapers of behaviour found in Normalisation Process Theory (May et al 2007. Neither of these approaches claims to be full blown theories but both claim to provide mid-range theoretical arguments which may be used to structure existing data and which can be undercut or reinforced by new data. Results and discussion. Many barriers and facilitators to integrating care are those of any large scale organisational change. These include issues relating to leadership, organisational culture, information technology, physician involvement, and availability of resources. However, activities which appear particularly important for delivering integrated care include personal relationships between leaders in different organisations, the scale of planned activities, governance and finance arrangements, support for staff in new roles, and organisational and staff stability. We illustrate our analyses with a 'routemap' which identifies questions that providers may wish to consider when

  11. Barriers and facilitators to integrating care: experiences from the English Integrated Care Pilots

    Directory of Open Access Journals (Sweden)

    Tom Ling

    2012-07-01

    Full Text Available Background. In 2008, the English Department of Health appointed 16 'Integrated Care Pilots' which used a range of approaches to provide better integrated care. We report qualitative analyses from a three year multi-method evaluation to identify barriers and facilitators to successful integration of care. Theory and methods. Data were analysed from transcripts of 213 in-depth staff interviews, and from semi-structured questionnaires (the 'Living Document' completed by staff in pilot sites at six points over a two-year period. Emerging findings were therefore built from 'bottom up' and grounded in the data. However, we were then interested in how these findings compared and contrasted with more generic analyses. Therefore after our analyses were complete we then systematically compared and contrasted the findings with the analysis of barriers and facilitators to quality improvement identified in a systematic review by Kaplan et al (2010 and the analysis of more micro-level shapers of behaviour found in Normalisation Process Theory (May et al 2007. Neither of these approaches claims to be full blown theories but both claim to provide mid-range theoretical arguments which may be used to structure existing data and which can be undercut or reinforced by new data.Results and discussion. Many barriers and facilitators to integrating care are those of any large scale organisational change. These include issues relating to leadership, organisational culture, information technology, physician involvement, and availability of resources. However, activities which appear particularly important for delivering integrated care include personal relationships between leaders in different organisations, the scale of planned activities, governance and finance arrangements, support for staff in new roles, and organisational and staff stability. We illustrate our analyses with a 'routemap' which identifies questions that providers may wish to consider when planning

  12. Impact of post-operative radiation on coronary arteries in patients of early breast cancer: A pilot dosimetric study from a tertiary cancer care center from India

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    S Roy

    2015-01-01

    Full Text Available Background: The significant impact of postoperative radiotherapy (PORT on cardiac morbidity in patients of early breast cancer (EBC undergoing breast-conserving surgery has been shown in different studies. The present study was conducted to assess the impact of surgery and the side of involvement on radiation dose to left anterior descending artery (LAD and Left circumflex coronary artery (LCx. Materials And Methods: Totally, 58 patients of EBC were randomly chosen for this dosimetric study and planned with tangential field technique without intensity modulation (IM. Heart, LAD, and LCx (n = 55 were contoured. Dose volume histograms were analyzed to determine the Dmax (maximum dose and Dmean (mean dose of LAD and LCx. Student's t-test was used for comparative analysis of the means. Results: The mean Dmax of LAD for left (L EBC was 3.17 Gray (Gy while for right (R EBC it was 0.86 Gy (P = 0.007; 95% C.I, 1.14–3.48. The mean Dmean of LAD for L-EBC and R-EBC were 1.97 Gy and 0.79 Gy, respectively (P = 0.029; 95% C.I, 0.77–1.60. The mean-Dmax of LCx for patients with L-EBC (2.9 Gy; range: 1.2–4.35 Gy was statistically higher than that for R-EBC (1.3 Gy; range: 0.7–3.2 Gy (P = 0.045. The mean-Dmean of LCx for L-EBC (2.1 Gy; range: 0.6–3.6 Gy was also significantly higher than that of L-EBC (0.9 Gy; range: 0.7–2.1 Gy (P = 0.03. There was no significant impact of the pattern of surgery on LAD dose, but significance was noted for LCx dose parameters (P = 0.04 and 0.08 for m-Dmax and m-Dmean of LCx. Conclusion: This pilot dosimetric study confirms the assumption that patients with left-sided EBC are at higher risk of developing long-term cardiac morbidity when treated with PORT due to increased dose to LAD.

  13. Kansas Primary Care Weighs In: A Pilot Randomized Trial of a Chronic Care Model Program for Obesity in 3 Rural Kansas Primary Care Practices

    Science.gov (United States)

    Ely, Andrea C.; Banitt, Angela; Befort, Christie; Hou, Qing; Rhode, Paula C.; Grund, Chrysanne; Greiner, Allen; Jeffries, Shawn; Ellerbeck, Edward

    2008-01-01

    Context: Obesity is a chronic disease of epidemic proportions in the United States. Primary care providers are critical to timely diagnosis and treatment of obesity, and need better tools to deliver effective obesity care. Purpose: To conduct a pilot randomized trial of a chronic care model (CCM) program for obesity care in rural Kansas primary…

  14. A pet-type robot AIBO-assisted therapy as a day care program for chronic schizophrenia patients: A pilot study

    Directory of Open Access Journals (Sweden)

    Shin Narita

    2016-07-01

    Full Text Available Background AAT (Animal-assisted therapy was developed to promote human social and emotional functioning as a day care program for psychiatric patients. Aims In this study, we performed AAT using a pet-type robot, AIBO for schizophrenic patients. Methods After obtaining informed consent, we performed the AIBO-assisted therapy for three schizophrenic (ICD-10, F20.x2 patients (male: 1, female: 2 whose medication did not change over the 8 weeks study period in a ward. Results It was found that the AAT using AIBO may be useful for the patients with negative and general psychopathological symptoms such as “Anxiety” and “Uncooperativeness”. Conclusion We make use of this result, and we want to develop the AAT program using a pet-type robot, AIBO which may be suitable for Japanese psychiatric patients.

  15. The UPBEAT nurse-delivered personalized care intervention for people with coronary heart disease who report current chest pain and depression: a randomised controlled pilot study.

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    Elizabeth A Barley

    Full Text Available BACKGROUND: Depression is common in people with coronary heart disease (CHD and associated with worse outcome. This study explored the acceptability and feasibility of procedures for a trial and for an intervention, including its potential costs, to inform a definitive randomized controlled trial (RCT of a nurse-led personalised care intervention for primary care CHD patients with current chest pain and probable depression. METHODS: Multi-centre, outcome assessor-blinded, randomized parallel group study. CHD patients reporting chest pain and scoring 8 or more on the HADS were randomized to personalized care (PC or treatment as usual (TAU for 6 months and followed for 1 year. Primary outcome was acceptability and feasibility of procedures; secondary outcomes included mood, chest pain, functional status, well being and psychological process variables. RESULT: 1001 people from 17 General Practice CHD registers in South London consented to be contacted; out of 126 who were potentially eligible, 81 (35% female, mean age = 65 SD11 years were randomized. PC participants (n = 41 identified wide ranging problems to work on with nurse-case managers. Good acceptability and feasibility was indicated by low attrition (9%, high engagement and minimal nurse time used (mean/SD = 78/19 mins assessment, 125/91 mins telephone follow up. Both groups improved on all outcomes. The largest between group difference was in the proportion no longer reporting chest pain (PC 37% vs TAU 18%; mixed effects model OR 2.21 95% CI 0.69, 7.03. Some evidence was seen that self efficacy (mean scale increase of 2.5 vs 0.9 and illness perceptions (mean scale increase of 7.8 vs 2.5 had improved in PC vs TAU participants at 1 year. PC appeared to be more cost effective up to a QALY threshold of approximately £3,000. CONCLUSIONS: Trial and intervention procedures appeared to be feasible and acceptable. PC allowed patients to work on unaddressed problems and appears cheaper than TAU

  16. Feasibility and benefits of group-based exercise in residential aged care adults: a pilot study for the GrACE programme

    Directory of Open Access Journals (Sweden)

    Samantha Fien

    2016-05-01

    Full Text Available The objective of the study was to examine the feasibility and benefits of a group resistance training exercise programme for improving muscle function in institutionalised older adults. A feasibility and acceptability study was designed for a residential aged care (RAC facility, based on the Gold Coast, Australia. Thirty-seven adults, mean age 86.8 ± 6.1 years (30 females living in a RAC facility. Participants were allocated into an exercise (n = 20 or control (n = 17 group. The exercise group, the Group Aged Care Exercise (GrACE programme, performed 12 weeks of twice weekly resistance exercises. Feasibility was measured via recruitment rate, measurement (physiological and surveys completion rate, loss-to-follow-up, exercise session adherence, adverse events, and ratings of burden and acceptability. Muscle function was assessed using gait speed, sit-to-stand and handgrip strength assessments. All intervention participants completed pre- and post-assessments, and the exercise intervention, with 85% (n = 17 of the group attending ≥ 18 of the 24 sessions and 15% (n = 3 attending all sessions. Acceptability was 100% with exercise participants, and staff who had been involved with the programme strongly agreed that the participants “Benefited from the programme.” There were no adverse events reported by any participants during the exercise sessions. When compared to the control group, the exercise group experienced significant improvements in gait speed (F(4.078 = 8.265, p = 0.007, sit to stand performance (F(3.24 = 11.033, p = 0.002 and handgrip strength (F(3.697 = 26.359, p < 0.001. Resistance training via the GrACE programme is feasible, safe and significantly improves gait speed, sit-to-stand performance and handgrip strength in RAC adults.

  17. Evaluating the effects of diffused lavender in an adult day care center for patients with dementia in an effort to decrease behavioral issues: a pilot study

    Science.gov (United States)

    Moorman Li, Robin; Gilbert, Brian; Orman, Anna; Aldridge, Petra; Leger-Krall, Sue; Anderson, Clare; Hincapie Castillo, Juan

    2017-01-01

    Abstract Objectives: To evaluate the effects of diffused lavender on the frequency of behavioral issues [BIs], defined as a composite of restlessness/wandering [RW], agitation [AGT], anger [ANG], and anxiety [ANX] in an adult day care center. Secondary objectives evaluate systematic differences on the frequency of BIs between age cohorts, gender, and individual behaviors. Design: Pre-post quasi-experimental study. Setting: Private nonprofit adult day care center for patients with dementia. Participants: Elderly patients older than 65 years of age with a clinical diagnosis of dementia, who require daytime monitoring. Intervention: Lavender aromatherapy twice a day for 20 min during a two-month period during active clinic days. Measurements: Behavioral issues were recorded using the behavior/intervention monthly flow record during the pre- and post-intervention periods. Results: There was no significant difference on frequency of BIs between pre-intervention and post-intervention periods (p = .06). There was a significant difference between pre-intervention and post-intervention total number of AGT occurrences (129 vs. 25; p value < .01). There was no significant difference between age cohorts for computed difference of RW, ANG, and ANX issues. There was a significant difference between age cohorts for computed difference of AGT (p value = .04) as the 70–85 age cohort showed less agitation compared to the 85–100 age cohort. Conclusion: The use of diffused lavender twice daily has shown to reduce the frequency of agitation in elderly patients with dementia, especially in the 70–85 age cohort. Though diffused lavender did not show statistical differences in the frequency of other behaviors (restlessness/wander, anger, anxiety), the study population may have been too small to find a difference.

  18. Treating Anxiety Disorders in Inner City Schools: Results from a Pilot Randomized Controlled Trial Comparing CBT and Usual Care

    Science.gov (United States)

    Ginsburg, Golda S.; Becker, Kimberly D.; Drazdowski, Tess K.; Tein, Jenn-Yun

    2012-01-01

    Background: The effectiveness of cognitive-behavioral treatment (CBT) in inner city schools, when delivered by novice CBT clinicians, and compared to usual care (UC), is unknown. Objective: This pilot study addressed this issue by comparing a modular CBT for anxiety disorders to UC in a sample of 32 volunteer youth (mean age 10.28 years, 63%…

  19. Testing feasibility and reliability of a set of quality indicators to evaluate the organization of palliative care across Europe: a pilot study in 25 countries

    NARCIS (Netherlands)

    Woitha, K.; Hasselaar, J.G.; Beek, K.; Ahmed, N.; Jaspers, B.; Hendriks, J.C.M.; Radbruch, L.; Vissers, K.; Engels, Y.M.

    2015-01-01

    BACKGROUND: A well-organized palliative care service is a prerequisite for offering good palliative care. Reliable and feasible quality indicators are needed to monitor the quality of their organization. AIM: To test feasibility and reliability of a previously developed set of quality indicators in

  20. The ENIQ pilot study: current status

    Energy Technology Data Exchange (ETDEWEB)

    Lemaitre, P.; Eriksen, B.; Crutzen, S. [European Commission, DG Joint Research Centre, Petten (Netherlands); Hansch, M. [Preussische Elektrizitaets-AG (Preussenelektra), Hannover (Germany); Whittle, J. [AEA Technology, Warrington (United Kingdom)

    1998-11-01

    A pilot study is currently being carried out by ENIQ (European Network for Inspection Qualification) in order to explore the issues involved in inspection qualification applied along the general principles of the European methodology. The components selected for the pilot study are austenitic pipe to pipe and pipe to elbows welds typical of those in BWR recirculation loops. A range of defect parameters has been defined. A suitable inspection procedure designed to find the designated defects will be applied to geometrically representative test pieces. The procedure/equipment will be qualified through open trials and technical justification. The personnel qualification will be done in a blind way. Once all features of the inspection system will have been qualified an in-service inspection will be simulated in order to test the feasibility of the qualification approach followed. In this paper the current status of this pilot study is discussed. (orig.)

  1. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation

    Science.gov (United States)

    Ncube, Alexander Tshaka; Sweeney, Sedona; Fleischer, Colette; Mumba, Grace Tembo; Gill, Michelle M.; Strasser, Susan; Peeling, Rosanna W.; Terris-Prestholt, Fern

    2015-01-01

    Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider’s perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015) elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16) was more than triple the pilot unit cost ($3.19). While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into antenatal care in

  2. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation.

    Directory of Open Access Journals (Sweden)

    Katharine D Shelley

    Full Text Available Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider's perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015 elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16 was more than triple the pilot unit cost ($3.19. While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into

  3. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation.

    Science.gov (United States)

    Shelley, Katharine D; Ansbro, Éimhín M; Ncube, Alexander Tshaka; Sweeney, Sedona; Fleischer, Colette; Tembo Mumba, Grace; Gill, Michelle M; Strasser, Susan; Peeling, Rosanna W; Terris-Prestholt, Fern

    2015-01-01

    Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider's perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015) elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16) was more than triple the pilot unit cost ($3.19). While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into antenatal care in

  4. Additive Complex Ayurvedic Treatment in Patients with Fibromyalgia Syndrome Compared to Conventional Standard Care Alone: A Nonrandomized Controlled Clinical Pilot Study (KAFA Trial

    Directory of Open Access Journals (Sweden)

    Christian S. Kessler

    2013-01-01

    Full Text Available Background. Fibromyalgia (FMS is a challenging condition for health care systems worldwide. Only limited trial data is available for FMS for outcomes of complex treatment interventions of complementary and integrative (CIM approaches. Methods. We conducted a controlled, nonrandomized feasibility study that compared outcomes in 21 patients treated with Ayurveda with those of 11 patients treated with a conventional approach at the end of a two-week inpatient hospital stay. Primary outcome was the impact of fibromyalgia on patients as assessed by the FIQ. Secondary outcomes included scores of pain intensity, pain perception, depression, anxiety, and quality of sleep. Follow-up assessments were done after 6 months. Results. At 2 weeks, there were comparable and significant improvements in the FIQ and for most of secondary outcomes in both groups with no significant in-between-group differences. The beneficial effects for both treatment groups were partly maintained for the main outcome and a number of secondary outcomes at the 6-month followup, again with no significant in-between-group differences. Discussion. The findings of this feasibility study suggest that Ayurvedic therapy is noninferior to conventional treatment in patients with severe FMS. Since Ayurveda was only used as add-on treatment, RCTs on Ayurveda alone are warranted to increase model validity. This trial is registered with NCT01389336.

  5. Health-promoting residential aged care: a pilot project in Austria.

    Science.gov (United States)

    Krajic, Karl; Cichocki, Martin; Quehenberger, Viktoria

    2015-09-01

    Long-term care for the aged is an area that has not been in the focus of health promotion so far. The paper describes context, concept and project plan of a 2-year pilot project of comprehensive health-promoting setting development in residential aged care in Austria, and provides an overview over main experiences and results. Austria's most relevant health promotion agencies, a specialized scientific institute and Austria's largest provider of aged care acted as partners. The project aimed at developing elements of a comprehensive approach, but also providing evidence for the effectiveness of health promotion. Therefore, the project combined an organizational development approach with a scientific, randomized controlled study on mobility enhancement for residents. A comprehensive settings approach turned out acceptable for the main stakeholders of aged care (owners and management, staff, residents and residents' relatives). Strategy development, based on a systematic needs assessment, found staff health to be of special interest for the organization (ergonomics, workability over life course), and residents' relatives, got more attention. The mobility study was able to achieve positive results on occupational performance, concerning quality-of-life indicators and reached also formerly inactive groups. After the end of the project, health promotion is still on the agenda of the organization; further developments will be monitored. Good support from the policy level and well-established networking between the aged care provider, health promotion agencies and a network for health promotion in health care seems to have been an important resource for success.

  6. Lymphocyte count as a sign of immunoparalysis and its correlation with nutritional status in pediatric intensive care patients with sepsis: A pilot study

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    Talita Freitas Manzoli

    Full Text Available OBJECTIVES: Developing malnutrition during hospitalization is well recognized worldwide, and children are at a relatively higher risk for malnutrition than adults. Malnutrition can lead to immune dysfunction, which is associated with a higher mortality rate due to sepsis, the most frequent cause of death in pediatric intensive care units (PICUs. The aim of this study was to investigate whether malnourished patients are more likely to have relative or absolute lymphopenia and, consequently, worse prognoses. METHODS: We enrolled 14 consecutive patients with sepsis whose legal representatives provided written informed consent. Patients were classified as normal or malnourished based on anthropometric measurements. As an additional evaluation of nutritional status, serum albumin and zinc were measured on the 1st and 7th days of hospitalization. Lymphocyte count was also measured on the 1st and 7th days. Clinicaltrials.gov: NCT02698683. RESULTS: Malnutrition prevalence rates were 33.3% and 42.8% based on weight and height, respectively. Laboratory analyses revealed a reduction of serum albumin in 100% of patients and reduction of zinc in 93.3% of patients. A total of 35% of patients had fewer than 500 lymphocytes/mm3 on their first day in the PICU. Lymphocyte counts and zinc concentrations significantly increased during hospitalization. CONCLUSIONS: Nutritional evaluations, including anthropometric measurements, were not correlated with lymphocyte counts. Lymphocyte counts concomitantly increased with zinc levels, suggesting that micronutrient supplementation benefits patients with sepsis.

  7. Lymphocyte count as a sign of immunoparalysis and its correlation with nutritional status in pediatric intensive care patients with sepsis: A pilot study

    Science.gov (United States)

    Manzoli, Talita Freitas; Delgado, Artur Figueiredo; Troster, Eduardo Juan; de Carvalho, Werther Brunow; Antunes, Ana Caroline Barreto; Marques, Desirée Mayara; Zamberlan, Patrícia

    2016-01-01

    OBJECTIVES: Developing malnutrition during hospitalization is well recognized worldwide, and children are at a relatively higher risk for malnutrition than adults. Malnutrition can lead to immune dysfunction, which is associated with a higher mortality rate due to sepsis, the most frequent cause of death in pediatric intensive care units (PICUs). The aim of this study was to investigate whether malnourished patients are more likely to have relative or absolute lymphopenia and, consequently, worse prognoses. METHODS: We enrolled 14 consecutive patients with sepsis whose legal representatives provided written informed consent. Patients were classified as normal or malnourished based on anthropometric measurements. As an additional evaluation of nutritional status, serum albumin and zinc were measured on the 1st and 7th days of hospitalization. Lymphocyte count was also measured on the 1st and 7th days. Clinicaltrials.gov: NCT02698683. RESULTS: Malnutrition prevalence rates were 33.3% and 42.8% based on weight and height, respectively. Laboratory analyses revealed a reduction of serum albumin in 100% of patients and reduction of zinc in 93.3% of patients. A total of 35% of patients had fewer than 500 lymphocytes/mm3 on their first day in the PICU. Lymphocyte counts and zinc concentrations significantly increased during hospitalization. CONCLUSIONS: Nutritional evaluations, including anthropometric measurements, were not correlated with lymphocyte counts. Lymphocyte counts concomitantly increased with zinc levels, suggesting that micronutrient supplementation benefits patients with sepsis. PMID:27982165

  8. Implementing a Pharmacist-Led Medication Management Pilot to Improve Care Transitions

    Directory of Open Access Journals (Sweden)

    Rachel Root, PharmD, MS

    2012-01-01

    Full Text Available Purpose: The purpose of this project was to design and pilot a pharmacist-led process to address medication management across the continuum of care within a large integrated health-system.Summary: A care transitions pilot took place within a health-system which included a 150-bed community hospital. The pilot process expanded the pharmacist’s medication management responsibilities to include providing discharge medication reconciliation, a patient-friendly discharge medication list, discharge medication education, and medication therapy management (MTM follow-up.Adult patients with a predicted diagnosis-related group (DRG of congestive heart failure or chronic obstructive pulmonary disease admitted to the medical-surgical and intensive care units who utilized a primary care provider within the health-system were included in the pilot. Forty patients met the inclusion criteria and thirty-four (85% received an intervention from an inpatient or MTM pharmacist. Within this group of patients, 88 drug therapy problems (2.6 per patient were identified and 75% of the drug therapy recommendations made by the pharmacist were accepted by the care provider. The 30-day all-cause readmission rates for the intervention and comparison groups were 30.5% and 35.9%, respectively. The number of patients receiving follow-up care varied with 10 (25% receiving MTM follow-up, 26 (65% completing a primary care visit after their first hospital discharge, and 23 (58% receiving a home care visit.Conclusion: Implementation of a pharmacist-led medication management pilot across the continuum of care resulted in an improvement in the quality of care transitions within the health-system through increased identification and resolution of drug therapy problems and MTM follow-up. The lessons learned from the implementation of this pilot will be used to further refine pharmacy care transitions programs across the health-system.

  9. Improving the care of people with long-term conditions in primary care: protocol for the ENHANCE pilot trial

    Directory of Open Access Journals (Sweden)

    Emma L. Healey

    2015-12-01

    Full Text Available Background: Long-term conditions (LTCs are important determinants of quality of life and healthcare expenditure worldwide. Whilst multimorbidity is increasingly the norm in primary care, clinical guidelines and the delivery of care remain focused on single diseases, resulting in poorer clinical outcomes. Osteoarthritis, and anxiety and/or depression frequently co-occur with other LTCs, yet are seldom prioritized by the patient or clinician, resulting in higher levels of disability, poorer prognosis, and increased healthcare costs. Objective: To examine the feasibility and acceptability of an integrated approach to LTC management, tackling the under-diagnosis and under-management of osteoarthritis-related pain and anxiety and/or depression in older adults with other LTCs in primary care. Design: The ENHANCE study is a pilot stepped-wedge cluster randomized controlled trial to test the feasibility and acceptability of a nurse-led ENHANCE LTC review consultation for identifying, assessing, and managing joint pain, and anxiety and/or depression in patients attending LTC reviews. Specific objectives (process evaluation and research outcomes will be achieved through a theoretically informed mixed-methods approach using participant self-reported questionnaires, a medical record review, an ENHANCE EMIS template, qualitative interviews, and audio recordings of the ENHANCE LTC review. Discussion: Success of the pilot trial will be measured against the level of the primary care team engagement, assessment of training delivery, and degree of patient recruitment and retention. Patient satisfaction and treatment fidelity will also be explored. ISRCTN registry number: 12154418. Journal of Comorbidity 2015;5(1:135–149

  10. Enhancing Patient Safety Using Clinical Nursing Data: A Pilot Study.

    Science.gov (United States)

    Choi, Jeeyae; Choi, Jeungok E

    2016-01-01

    To enhance patient safety from falls, many hospital information systems have been implemented to collect clinical data from the bedside and have used the information to improve fall prevention care. However, most of them use administrative data not clinical nursing data. This necessitated the development of a web-based Nursing Practice and Research Information Management System (NPRIMS) that processes clinical nursing data to measure nurses' delivery of fall prevention care and its impact on patient outcomes. This pilot study developed computer algorithms based on a falls prevention protocol and programmed the prototype NPRIMS. It successfully measured the performance of nursing care delivered and its impact on patient outcomes using clinical nursing data from the study site. Results of the study revealed that NPRIMS has the potential to pinpoint components of nursing processes that are in need of improvement for preventing patient from falls.

  11. Microbial field pilot study. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, R.M.; McInerney, M.J.; Menzie, D.E.; Coates, J.D.; Chisholm, J.L.

    1993-05-01

    A multi-well microbially enhanced oil recovery field pilot has been performed in the Southeast Vassar Vertz Sand Unit in Payne County, Oklahoma. The primary emphasis of the experiment was preferential plugging of high permeability zones for the purpose of improving waterflood sweep efficiency. Studies were performed to determine reservoir chemistry, ecology, and indigenous bacteria populations. Growth experiments were used to select a nutrient system compatible with the reservoir that encouraged growth of a group of indigenous nitrate-using bacteria and inhibit growth of sulfate-reducing bacteria. A specific field pilot area behind an active line drive waterflood was selected. Surface facilities were designed and installed. Injection protocols of bulk nutrient materials were prepared to facilitate uniform distribution of nutrients within the pilot area. By the end of December, 1991, 82.5 tons (75.0 tonnes) of nutrients had been injected in the field. A tracer test identified significant heterogeneity in the SEVVSU and made it necessary to monitor additional production wells in the field. The tracer tests and changes in production behavior indicate the additional production wells monitored during the field trial were also affected. Eighty two and one half barrels (13.1 m{sup 3}) of tertiary oil have been recovered. Microbial activity has increased CO{sub 2} content as indicated by increased alkalinity. A temporary rise in sulfide concentration was experienced. These indicate an active microbial community was generated in the field by the nutrient injection. Pilot area interwell pressure interference test results showed that significant permeability reduction occurred. The interwell permeabilities in the pilot area between the injector and the three pilot production wells were made more uniform which indicates a successful preferential plugging enhanced oil recovery project.

  12. A pilot study exploring quality of life experienced by patients undergoing negative-pressure wound therapy as part of their wound care treatment compared to patients receiving standard wound care.

    Science.gov (United States)

    Ousey, Karen J; Milne, Jeanette; Cook, Leanne; Stephenson, John; Gillibrand, Warren

    2014-08-01

    The use of negative pressure wound therapy (NPWT) has been widely documented as a technique to help heal complex wounds. This article presents the findings of a preliminary study which aimed to explore quality of life (QoL) experienced by patients undergoing NPWT as part of their wound care treatment in comparison to that of patients with a wound using traditional (standard) wound care therapies. A quasi-experimental study was undertaken, with patients treated in wound care/vascular clinics with chronic/acute wounds. QoL impact was measured using the Cardiff Wound Impact Schedule and administered post-consent at timed intervals. Our results identified that there were no real differences in QoL scores recorded by patients over the 12-week period. Although there was no overall interaction between the therapies used for wound healing, NPWT did have an effect on social life: during the first 2 weeks of the application of therapy, patients in the NPWT group reported an increase in the social life domain. The authors conclude that true QoL can only be elicited if an accurate baseline is established or if data is collected over a long enough period to allow comparison of scores over time.

  13. Interpersonal Community Psychiatric Treatment for non-psychotic chronic patients and nurses in outpatient mental health care: A controlled pilot study on feasibility and effects

    NARCIS (Netherlands)

    Koekkoek, B.; Meijel, B. van; Schene, A.; Smit, A.; Kaasenbrood, A.; Hutschemaekers, G.

    2011-01-01

    In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the authors. It

  14. [Management of psychiatric inpatients with advanced cancer: a pilot study].

    Science.gov (United States)

    Rhondali, Wadih; Ledoux, Mathilde; Sahraoui, Fatma; Marotta, Juliette; Sanchez, Vincent; Filbet, Marilène

    2013-09-01

    The prevalence of cancer is not well established and probably underestimated in long-stay psychiatric inpatients. Psychiatric patients do not have the same access for cancer screening and care. Therapeutic decision-making is a real ethical problem. In this context, access to medical care should be provided by the establishment of guidelines and/or recommendations for this specific population. The aim of our study was to assess how cancer was managed among long term psychiatric inpatients. For this pilot study, we used a mixed methodology: a quantitative part with a retrospective chart review of cancer patients in a psychiatric institution and a qualitative part based on semi-structured interviews with psychiatrists with discourse analysis. Delay in cancer diagnosis can be explained by communication and behavior disorders, inadequate screening, and additional tests often refused by patients. Compliance and ethical issues (i.e. obtaining informed consent) are many pitfalls to optimal cancer care that should be explored in further research.

  15. Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities

    Directory of Open Access Journals (Sweden)

    Peisah C

    2014-10-01

    Full Text Available Carmelle Peisah,1–3 Judith Weaver,1 Lisa Wong,1 Julie-Anne Strukovski1 1Behaviour Assessment Management Service, Specialist Mental Health Services for Older People, Mental Health Drug and Alcohol, Northern Sydney Local Health District, 2University of Sydney, 3University of NSW, Sydney, NSW, Australia Background: Pain is common in older people, particularly those in residential aged care facilities (RACF and those with dementia. However, despite 20 years of discourse on pain and dementia, pain is still undetected or misinterpreted in people with dementia in residential aged care facilities, particularly those with communication difficulties. Methods: A topical survey typology with semistructured interviews was used to gather attitudes and experiences of staff from 15 RACF across Northern Sydney Local Health District. Results: While pain is proactively assessed and pain charts are used in RACF, this is more often regulatory-driven than patient-driven (eg, prior to accreditation. Identification of pain and need for pain relief was ill defined and poorly understood. Both pharmacological and nonpharmacological regimes were used, but in an ad hoc, variable and unsystematic manner, with patient, staff, and attitudinal obstacles between the experience of pain and its relief.Conclusion: A laborious “pain communication chain” exists between the experience of pain and its relief for people with severe dementia within RACF. Given the salience of pain for older people with dementia, we recommend early, proactive consideration and management of pain in the approach to behaviors of concern. Individualized pain measures for such residents; empowerment of nursing staff as “needs interpreters”; collaborative partnerships with common care goals between patients where possible; RACF staff, doctors, and family carers; and more meaningful use of pain charts to map response to stepped pain protocols may be useful strategies to explore in clinical settings

  16. Cytogenetics of jaw cysts - a pilot study.

    Science.gov (United States)

    Manor, Esther; Brennan, Peter A; Bodner, Lipa

    2012-07-01

    The pathogenesis of cysts that arise in the jaws is still not certain, and the underlying mechanisms of epithelial proliferation are not fully understood. Cysts of the jaw may involve a reactive, inflammatory, or neoplastic process. Cytogenetics, the study of the number and structure of chromosomes, has provided valuable information about the diagnosis, prognosis, and targeted treatment in many cancers, including oral squamous cell carcinoma. Cytogenetics can also provide information about the possible aetiology or neoplastic potential of a lesion, though to our knowledge no studies of this technique have been used for cysts in the jaws. In this pilot study we used cytogenetics in a series of 10 cysts (3 radicular, 4 dentigerous, 2 of the nasopalatine duct, and 1 dermoid). In all cases we found normal karyotypes. Further work and larger numbers are needed for a definitive study, but we can hypothesise from this pilot study that these cysts do not have cytogenetic aberrations and so have no neoplastic potential.

  17. Chiropractic manipulation in Adolescent Idiopathic Scoliosis: a pilot study

    Directory of Open Access Journals (Sweden)

    Stoline Michael R

    2006-08-01

    Full Text Available Abstract Background Adolescent idiopathic scoliosis (AIS remains the most common deforming orthopedic condition in children. Increasingly, both adults and children are seeking complementary and alternative therapy, including chiropractic treatment, for a wide variety of health concerns. The scientific evidence supporting the use chiropractic intervention is inadequate. The purpose of this study was to conduct a pilot study and explore issues of safety, patient recruitment and compliance, treatment standardization, sham treatment refinement, inter-professional cooperation, quality assurance, and outcome measure selection. Methods Six patients participated in this 6-month study, 5 of whom were female. One female was braced. The mean age of these patients was 14 years, and the mean Cobb angle was 22.2 degrees. The study design was a randomized controlled clinical trial with two independent and blinded observers. Three patients were treated by standard medical care (observation or brace treatment, two were treated with standard medical care plus chiropractic manipulation, and one was treated with standard medical care plus sham manipulation. The primary outcome measure was Cobb, and the psychosocial measure was Scoliosis Quality of Life Index. Results Orthopedic surgeons and chiropractors were easily recruited and worked cooperatively throughout the trial. Patient recruitment and compliance was good. Chiropractic treatments were safely employed, and research protocols were successful. Conclusion Overall, our pilot study showed the viability for a larger randomized trial. This pilot confirms the strength of existing protocols with amendments for use in a full randomized controlled trial. Trial registration This trial has been assigned an international standard randomized controlled trial number by Current Controlled Trials, Ltd. http://www.controlled-trials.com/isrctn/. The number is ISRCTN41221647.

  18. Carbapenemase-producing Enterobacteriaceae in Irish critical care units: results of a pilot prevalence survey, June 2011.

    LENUS (Irish Health Repository)

    Burns, K

    2012-11-10

    The epidemiology of carbapenemase-producing Enterobacteriaceae (CPE) in Ireland is changing, with an increase in the number of reported cases in late 2010 and early 2011. Reported cases were predominantly linked to critical care units. In June 2011, a four-week national pilot survey took place in 40 Irish critical care units (37 adult and three paediatric) to examine the prevalence of rectal carriage of CPE and inform national CPE screening guidelines. A total of 760 screening swabs were taken over the study period, and CPE were not detected in any of the participating critical care units.

  19. Piloting the role of a pharmacist in a community palliative care multidisciplinary team: an Australian experience

    Directory of Open Access Journals (Sweden)

    Box Margaret

    2011-10-01

    Full Text Available Abstract Background While the home is the most common setting for the provision of palliative care in Australia, a common problem encountered here is the inability of patient/carers to manage medications, which can lead to misadventure and hospitalisation. This can be averted through detection and resolution of drug related problems (DRPs by a pharmacist; however, they are rarely included as members of the palliative care team. The aim of this study was to pilot a model of care that supports the role of a pharmacist in a community palliative care team. A component of the study was to develop a cost-effective model for continuing the inclusion of a pharmacist within a community palliative care service. Methods The study was undertaken (February March 2009-June 2010 in three phases. Development (Phase 1 involved a literature review; scoping the pharmacist's role; creating tools for recording DRPs and interventions, a communication and education strategy, a care pathway and evidence based patient information. These were then implemented in Phase 2. Evaluation (Phase 3 of the impact of the pharmacist's role from the perspectives of team members was undertaken using an online survey and focus group. Impact on clinical outcomes was determined by the number of patients screened to assess their risk of medication misadventure, as well as the number of medication reviews and interventions performed to resolve DRPs. Results The pharmacist screened most patients (88.4%, 373/422 referred to the palliative care service to assess their risk of medication misadventure, and undertook 52 home visits. Medication reviews were commonly conducted at the majority of home visits (88%, 46/52, and a variety of DRPs (113 were detected at this point, the most common being "patient requests drug information" (25%, 28/113 and "condition not adequately treated" (22%, 25/113. The pharmacist made 120 recommendations in relation to her interventions. Fifty percent of online

  20. Breakthrough Listen on MWA Pilot Study

    Science.gov (United States)

    Croft, S.; Siemion, A.; Kaplan, D. L.; Tremblay, S.

    2016-07-01

    We propose a pilot study, using the Voltage Capture System, for Breakthrough Listen on the MWA. Breakthrough Listen (BL) is a major new project that aims to dramatically improve the coverage of parameter space in the search for intelligent life beyond Earth. BL has already deployed hardware and software to the Green Bank Telescope, and will bring a similar program with the Parkes Telescope online in the second half of 2016. The low frequency sky is however currently very poorly explored. The superb capabilities of the MWA (large field of view, low frequency of operation, and location in a very radio quiet site) provide a unique opportunity for a pilot study to obtain voltage data for a SETI (Search For Extraterrestrial Intelligence) study of the Galactic Plane. We propose commensal observations, piggybacking on the proposed pulsar search of Tremblay et al. Using existing VCS software, combined with the pipeline developed for Breakthrough Listen at GBT and Parkes, we will perform a blind search for candidate signals from extraterrestrial intelligence. Although the chances of a detection are not large, particularly for a pilot study such as that proposed here, the Breakthrough Listen team plan to perform extensive testing and analysis on the data obtained which should be useful for other users of the MWA VCS. We will make the secondary SETI data products and associated documentation available as a resource to the community via the Breakthrough Listen online archive.

  1. Measuring primary care services performance: issues and opportunities from a home care pilot experience in the Tuscan health system.

    Science.gov (United States)

    Cinquini, Lino; Vainieri, Milena

    2008-08-01

    In recent years in Italy, as in other European countries, profound changes have been introduced in health care both at central and regional levels. Most of them were oriented towards a shift from 'hospital-centred' health care to health care based more on primary care services. This transition pursues two objectives: giving more effective responses to citizens' needs and reducing public health expenditure. Changes that involve organizational structure must also be carried out with the introduction of measurement tools that can help in planning and can control the changes. The paper provides the results obtained through the experience of modelling a measurement system for primary care carried out in 2004 and 2005 by some territorial managers and controllers in the Tuscan Health system, and the main issues in measuring primary care services emerging from this pilot experience focused on integrated home care services.

  2. Helicopter pilot back pain: a preliminary study.

    Science.gov (United States)

    Shanahan, D F; Reading, T E

    1984-02-01

    Because of the high prevalence of back pain experienced by U.S. Army helicopter pilots, a study was conducted to ascertain the feasibility of reproducing these symptoms in the laboratory. A mock-up of a UH-1H seat and control configuration was mounted to a multi-axis vibration simulator (MAVS). Eleven subjects were tested on the apparatus for two 120-min periods. During one period, the MAVS was programmed to reproduce vibrations recorded from a UH-1H in cruise flight. The subjects received no vibration during the other test period. All subjects reported back pain which they described as identical to the pain they experience during flight, during one or more of their test periods. There was no statistical difference between the vibration and nonvibration test conditions (p greater than 0.05) in terms of time of onset of pain or intensity of pain as measured by a visual analog scale. It appears the vibration at the frequencies and amplitudes tested plays little or no role in the etiology of the back symptoms reported by these pilots. It is proposed that the primary etiological factor for these symptoms is the poor posture pilots are obliged to assume for extended periods while operating helicopters.

  3. USGS Tampa Bay Pilot Study

    Science.gov (United States)

    Yates, K.K.; Cronin, T. M.; Crane, M.; Hansen, M.; Nayeghandi, A.; Swarzenski, P.; Edgar, T.; Brooks, G.R.; Suthard, B.; Hine, A.; Locker, S.; Willard, D.A.; Hastings, D.; Flower, B.; Hollander, D.; Larson, R.A.; Smith, K.

    2007-01-01

    Many of the nation's estuaries have been environmentally stressed since the turn of the 20th century and will continue to be impacted in the future. Tampa Bay, one the Gulf of Mexico's largest estuaries, exemplifies the threats that our estuaries face (EPA Report 2001, Tampa Bay Estuary Program-Comprehensive Conservation and Management Plan (TBEP-CCMP)). More than 2 million people live in the Tampa Bay watershed, and the population constitutes to grow. Demand for freshwater resources, conversion of undeveloped areas to resident and industrial uses, increases in storm-water runoff, and increased air pollution from urban and industrial sources are some of the known human activities that impact Tampa Bay. Beginning on 2001, additional anthropogenic modifications began in Tampa Bat including construction of an underwater gas pipeline and a desalinization plant, expansion of existing ports, and increased freshwater withdrawal from three major tributaries to the bay. In January of 2001, the Tampa Bay Estuary Program (TBEP) and its partners identifies a critical need for participation from the U.S. Geological Survey (USGS) in providing multidisciplinary expertise and a regional-scale, integrated science approach to address complex scientific research issue and critical scientific information gaps that are necessary for continued restoration and preservation of Tampa Bay. Tampa Bay stakeholders identified several critical science gaps for which USGS expertise was needed (Yates et al. 2001). These critical science gaps fall under four topical categories (or system components): 1) water and sediment quality, 2) hydrodynamics, 3) geology and geomorphology, and 4) ecosystem structure and function. Scientists and resource managers participating in Tampa Bay studies recognize that it is no longer sufficient to simply examine each of these estuarine system components individually, Rather, the interrelation among system components must be understood to develop conceptual and

  4. Homeopathic Secretin in autism: a clinical pilot study.

    Science.gov (United States)

    Robinson, T W

    2001-04-01

    Autism is a condition characterised by impairments of social communication, social interaction and social imagination. The exact aetiology of autism is unknown but some autistic features have been explained by the 'opioid excess theory' in which excess brain peptide levels have a morphine-like activity. Reduction of peptide levels by administration of the duodenal enzyme Secretin has been found to improve social and language skills in autistic patients. Homeopathic Secretin has been said to produce similar effects. A pilot study was undertaken to study these effects by administration of Secretin to a group of autistic patients. Weekly assessment for 12 weeks was performed by the patients' care workers. Statistical analysis of the mean pre-treatment results compared with the mean treatment results suggested a worsening in the autistic symptoms during treatment. Discussion with the care workers revealed changes and some improvements that were not recordable on the scoring system. Further research into Secretin treatment of autism using a more detailed and customized scoring system would be justified. Following this pilot study a randomised controlled trial of Secretin vs placebo would be appropriate.

  5. Vascular quality of care pilot study: how admission to a vascular surgery service affects evidence-based pharmacologic risk factor modification in patients with lower extremity peripheral arterial disease

    Directory of Open Access Journals (Sweden)

    Steenhof N

    2014-06-01

    Full Text Available Naomi Steenhof,1,2 Francesca Le Piane,1 Kori Leblanc,1–3 Naomi R Eisenberg,4 Yvonne Kwan,1 Christine Malmberg,1,6 Alexandra Papadopoulos,5,7 Graham Roche-Nagle4,7,8 1Department of Pharmacy, University Health Network, 2Leslie Dan Faculty of Pharmacy, University of Toronto, 3Centre for Innovation in Complex Care, University Health Network, 4Division of Vascular Surgery, University Health Network, 5Faculty of Nursing, University of Toronto, Toronto, ON, 6Victoria General Hospital, Vancouver Island Health Authority, Victoria, BC, 7Peter Munk Cardiac Centre, University Health Network, 8Faculty of Medicine, University of Toronto, Toronto, ON, Canada Background: Peripheral arterial disease (PAD guidelines recommend aggressive risk factor modification to improve cardiovascular outcomes. Recommended pharmacologic therapies include antiplatelets, angiotensin converting enzyme (ACE inhibitors, and HMG-CoA-reductase inhibitors (statins. Purpose: We studied the degree to which patient admission to a vascular surgery service increased the use of these therapies. Patients and methods: The authors conducted a retrospective chart review of 150 patients with PAD admitted to the vascular surgery service at a large Canadian tertiary care hospital. The use of recommended pharmacologic therapies at the time of admission and discharge were compared. A multidisciplinary clinical team established criteria by which patients were deemed ineligible to receive any of the recommended therapies. Angiotensin receptor blockers (ARBs were considered an alternative to ACE inhibitors. Results: Prior to hospital admission, 64% of patients were on antiplatelet therapy, 67% were on an ACE inhibitor or ARB, and 71% were on a statin. At the time of discharge, 91% of patients were on an antiplatelet (or not, with an acceptable reason, 77% were on an ACE inhibitor or an ARB (or not, with an acceptable reason, and 85% were on a statin (or not, with an acceptable reason. While new

  6. Involvement of practice nurses and allied health professionals in the development and management of care planning processes for patients with chronic disease – A pilot study

    OpenAIRE

    Jones, KM; Adaji, A; Schattner, PS

    2014-01-01

    Introduction: Medicare items were introduced in 2005 to encourage general practitioners (GPs) to involve other healthcare providers in the management of patients with chronic disease. However, there appears to be barriers to converting financial incentives and the use of information technology as a communication tool to better patient outcomes. The aim of this study was to explore these barriers from the perspectives of practice nurses and allied health practitioners.

  7. Development and pilot test of pictograph-enhanced breast health-care instructions for community-residing immigrant women.

    Science.gov (United States)

    Choi, Jeungok

    2012-08-01

    Current written text-based health-care instructions are not suitable for presenting lengthy, complex breast health-care instructions and are difficult for immigrant women with limited literacy skills. The aims of this study were to develop breast health-care instructions enhanced by pictographs (simple line drawings representing health-care actions) and pilot test the instructions in a sample of six immigrant women with limited literacy skills. Based on the Mayer's Cognitive Theory of Multimedia Learning, pictographs were developed in addition to low-literacy text. The text and the pictographs were then pilot tested with six immigrant women in community health centres for clarity, comprehension and acceptability through face-to-face interviews. Participants perceived that the drawings were engaging and enhanced clarity of the intended health-care messages. The black and white simple line drawings were well received by participants of varying race and ethnicity. The pictograph-based approach might be an effective tool in developing health-care instructions for immigrant women with limited literacy skills. Future research is needed to compare the effect of pictograph-enhanced instructions with written text-based instructions on adherence to instructions and health outcomes.

  8. Teaching methotrexate self-injection with a web-based video maintains patient care while reducing healthcare resources: a pilot study.

    Science.gov (United States)

    Katz, Steven J; Leung, Sylvia

    2015-01-01

    The aim of the study was to compare standard nurse-led methotrexate self-injection patient education to a web-based methotrexate self-injection education video in conjunction with standard teaching on patient self-confidence for self-injection, as well as patient satisfaction, patient knowledge and teaching time. Consecutive rheumatology patients seen for methotrexate self-injection education were enrolled. Prior to education, patient self-confidence for self-injection, age, gender and education were recorded. Patients were randomized 1:1 to standard teaching or the intervention: a 12-min methotrexate self-injection education video followed by further in-person nurse education. Patients recorded their post-education confidence for self-injection, satisfaction with the teaching process and answered four specific questions testing knowledge on methotrexate self-injection. The time spent providing direct education to the patient was recorded. Twenty-nine patients participated in this study: 15 had standard (C) teaching and 14 were in the intervention group (I). Average age, gender and education level were similar in both groups. Both groups were satisfied with the quality of teaching. There was no difference in pre-confidence (C = 5.5/10 vs. I = 4.7/10, p = 0.44) or post-confidence (C = 8.8, I = 8.8, p = 0.93) between the groups. There was a trend toward improved patient knowledge in the video group versus the standard group (C = 4.7/6, I = 5.5/6, p = 0.15). Nurse teaching time was less in the video group (C = 60 min, I = 44 min, p = 0.012), with men requiring longer education time than women across all groups. An education video may be a good supplement to standard in-person nurse teaching for methotrexate self-injection. It equals the standard teaching practise with regard to patient satisfaction, confidence and knowledge while decreasing teaching time by 25 %.

  9. Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care

    Directory of Open Access Journals (Sweden)

    Szecsenyi Joachim

    2011-04-01

    Full Text Available Abstract Background Primary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD, patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio, we have developed and tested a set of standardized measures, linked to previously developed quality indicators. Methods A structured stepwise procedure was followed to develop measures. First, the research team allocated 106 validated quality indicators to one of the three target populations (established CVD, at high risk, at low risk and to different data-collection methods (data abstraction from the medical records, a patient survey, an interview with lead practice GP/a practice survey. Secondly, we selected a number of other validated measures to enrich the assessment. A pilot study was performed to test the feasibility. Finally, we revised the measures based on the findings. Results The EPA-Cardio measures consisted of abstraction forms from the medical-records data of established Coronary Heart Disease (CHD-patients - and high-risk groups, a patient questionnaire for each of the 3 groups, an interview questionnaire for the lead GP and a questionnaire for practice teams. The measures were feasible and accepted by general practices from different countries. Conclusions An internationally standardized measure of cardiovascular risk management, linked to validated quality indicators and tested for feasibility in general practice, is now available. Careful development and pilot testing of the measures are crucial in international studies of quality of healthcare.

  10. Primary Medical Care Provider Accreditation (PMCPA): pilot evaluation.

    NARCIS (Netherlands)

    Campbell, S.M.; Chauhan, U.; Lester, H.

    2010-01-01

    BACKGROUND: While practice-level or team accreditation is not new to primary care in the UK and there are organisational indicators in the Quality and Outcomes Framework (QOF) organisational domain, there is no universal system of accreditation of the quality of organisational aspects of care in the

  11. Treatment of minor depression in older adults: A pilot study comparing sertraline and exercise

    OpenAIRE

    Brenes, Gretchen A; Williamson, Jeff D; Messier, Stephen P.; Rejeski, W Jack; Pahor, Marco; Ip, Edward; Penninx, Brenda W J H

    2007-01-01

    The purpose of this study was to conduct a pilot clinical trial to test the feasibility and efficacy of an exercise program and anti-depressant treatment compared with usual care in improving the emotional and physical functioning of older adults with minor depression. Participants were 37 older adults with minor depression who were randomized to exercise, sertraline, or usual care; 32 participants completed the 16 week study. Outcomes included measures of both emotional (clinician and self-r...

  12. A pilot study on the assessment of trace organic contaminants including pharmaceuticals and personal care products from on-site wastewater treatment systems along Skaneateles Lake in New York State, USA.

    Science.gov (United States)

    Subedi, Bikram; Codru, Neculai; Dziewulski, David M; Wilson, Lloyd R; Xue, Jingchuan; Yun, Sehun; Braun-Howland, Ellen; Minihane, Christine; Kannan, Kurunthachalam

    2015-04-01

    On-site wastewater treatment systems (OWTSs or septic systems) are designed to treat and dispose effluents on the same property that produces the wastewater. Approximately 25% of the U.S. population is served by such facilities. Nevertheless, studies on the treatment efficiency and discharge of organic contaminants through septic effluents are lacking. This pilot study showed the occurrence of organic contaminants including pharmaceuticals and personal care products (PPCPs), perfluoroalkyl surfactants (PFASs), polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs) in septic effluents, adjacent lake water samples, household drinking water in homes that use lake water or a well adjacent to the lake as a source of drinking water, and offshore lake water samples. Septic effluent as well as lake and tap water samples were collected from several households with OWTSs around Skaneateles Lake located in central New York. The advanced on-site systems were installed in some households for the purpose of limiting nutrient levels in the effluent to protect the local surface water. Additionally, because many of these systems serve homes with limited land, advanced treatment systems were needed. The median concentrations of ten PPCPs (ranged from 0.45 to 388 ng/L) and eleven PFASs (ranged from 0.20 to 14.6 ng/L) in septic water were significantly higher (p ≤ 0.01) than in lake water samples. The median concentrations of PPCPs and PFASs in lake and tap water samples were not significantly different (p ≥ 0.65). The median concentrations of ∑PBDEs in septic, lake, and tap water samples were 7.47, 3.49, and 2.22 ng/L, respectively, and those for ∑PCBs were 33.1, 29.2, and 28.6 ng/L, respectively. The mass flux of PPCPs (i.e. the mass flow of PPCPs per unit area per unit time) through the disposal of treated septic effluent from textile biofilter and aerobic treatments to the dispersal unit ranged from 12 (carbamazepine) to 66900 μg/m(2)/day

  13. Psycho-education programme for temporomandibular disorders: a pilot study

    Directory of Open Access Journals (Sweden)

    El Maaytah Mohammed

    2007-03-01

    Full Text Available Abstract Background Temporomandibular disorders (TMDs are by far the most predominant condition affecting the temporomandibular joint (TMJ, however many patients have mild self-limiting symptoms and should not be referred for specialist care. The aim of this pilot study was to develop a simple, cost-effective management programme for TMDs using CD-ROM. 41 patients (age 18–70 participated in this study, patients were divided into three groups: the 1st group were involved in an attention placebo CD-ROM (contain anatomical information about the temporomandibular system, the 2nd group received information on CD-ROM designed to increase their control and self efficacy, while the 3rd group received the same programme of the 2nd group added to it an introduction to self-relaxing techniques followed by audio tape of progressive muscle relaxation exercises. Each of the groups was asked to complete a number of questionnaires on the day of initial consultation and six weeks afterwards. Results The two experimental groups (2nd & 3rd were equally effective in reducing pain, disability and distress, and both were more effective than the attention placebo group (1st, however the experimental groups appeared to have improved at follow-up relative to the placebo-group in terms of disability, pain and depressed mood. Conclusion This pilot study demonstrates the feasibility and acceptability of the design. A full, randomized, controlled trial is required to confirm the efficacy of the interventions developed here.

  14. Location Independent Professional Project: A Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Hudson, J.A.; Long, J.P.; Miller, M.M.

    1999-02-01

    This pilot study project explored the problem of providing access to the nomadic worker who desires to connect a computer through network access points at a number of different locations within the SNL/NM campus as well as outside the campus. The design and prototype development gathered knowledge that may allow a design to be developed that could be extended to a larger number of SNL/NM network drop boxes. The focus was to provide a capability for a worker to access the SNL IRN from a network drop box (e.g. in a conference room) as easily as when accessing the computer network from the office normally used by the worker. Additional study was done on new methods to authenticate the off campus worker, and protect and control access to data.

  15. Development and Pilot of a Checklist for Management of Acute Liver Failure in the Intensive Care Unit.

    Directory of Open Access Journals (Sweden)

    Oren K Fix

    Full Text Available Acute liver failure (ALF is an ideal condition for use of a checklist. Our aims were to develop a checklist for the management of ALF in the intensive care unit (ICU and assess the usability of the checklist among multiple providers.The initial checklist was developed from published guidelines and expert opinion. The checklist underwent pilot testing at 11 academic liver transplant centers in the US and Canada. An anonymous, written survey was used to assess the usability and quality of the checklist. Written comments were used to improve the checklist following the pilot testing period.We received 81 surveys involving the management of 116 patients during the pilot testing period. The overall quality of the checklist was judged to be above average to excellent by 94% of users. On a 5-point Likert scale, the majority of survey respondents agreed or agreed strongly with the following checklist characteristics: the checklist was easy to read (99% agreed/agreed strongly, easy to use (97%, items are categorized logically (98%, time to complete the checklist did not interfere with delivery of appropriate and safe patient care (94% and was not excessively burdensome (92%, the checklist allowed the user the freedom to use his or her clinical judgment (80%, it is a useful tool in the management of acute liver failure (98%. Web-based and mobile apps were developed for use of the checklist at the point of care.The checklist for the management of ALF in the ICU was shown in this pilot study to be easy to use, helpful and accepted by a wide variety of practitioners at multiple sites in the US and Canada.

  16. Improving Homework Compliance in Career Counseling with a Behavioral Activation Functional Assessment Procedure: A Pilot Study

    Science.gov (United States)

    Baruch, David E.; Kanter, Jonathan W.; Bowe, William M.; Pfennig, Sherri L.

    2011-01-01

    Behavioral activation has emerged as a widely used treatment for depression in a number of health care settings due to its concrete, straightforward emphasis on out-of-session client homework, but it lacks explicit guidelines for identifying and overcoming barriers that interfere with homework completion. The purpose of this pilot study was to…

  17. Endoscopic procedure with a modified Reiki intervention: a pilot study.

    Science.gov (United States)

    Hulse, Rosalinda S; Stuart-Shor, Eileen M; Russo, Jonathan

    2010-01-01

    This pilot study examined the use of Reiki prior to colonoscopy to reduce anxiety and minimize intraprocedure medications compared with usual care. A prospective, nonblinded, partially randomized patient preference design was employed using 21 subjects undergoing colonoscopy for the first time. Symptoms of anxiety and pain were assessed using a Likert-type scale. Between-group differences were assessed using chi-square analyses and analysis of variance. There were no differences between the control (n = 10) and experimental (n = 11) groups on age (mean = 58 years, SD = 8.5) and gender (53% women). The experimental group had higher anxiety (4.5 vs. 2.6, p = .03) and pain (0.8 vs. 0.2, p = .42) scores prior to colonoscopy. The Reiki intervention reduced mean heart rate (-9 beats/minute), systolic blood pressure (-10 mmHg), diastolic blood pressure (-4 mmHg), and respirations (-3 breaths/minute). There were no between-group differences on intraprocedure medication use or postprocedure physiologic measures. Although the experimental group patients had more symptoms, they did not require additional pain medication during the procedure, suggesting that (1) anxious people may benefit from an adjunctive therapy; (2) anxiety and pain are decreased by Reiki therapy for patients undergoing colonoscopy, and (3) additional intraprocedure pain medication may not be needed for colonoscopy patients receiving Reiki therapy. This pilot study provided important insights in preparation for a rigorous, randomized, controlled clinical trial.

  18. TRICARE versus FEHBP: a pilot study of comparative inpatient costs in region 10.

    OpenAIRE

    Hone, Anne Burke.

    1997-01-01

    Approved for public release; distribution is unlimited Approximately 3.5 billion dollars of the Defense Budget for Fiscal Year 1997 was allocated for the care of non-active duty beneficiaries. This thesis is a pilot study exploring one option to restructure the military beneficiary health system. Two methods of health care delivery are examined: traditional fee-for-service plans, and health maintenance organizations (HMO) . The advantages, disadvantages, and cost implications associated wi...

  19. [Pilot study on compulsory vaccination coverage].

    Science.gov (United States)

    Grandolfo, M E; Lauria, L; Medda, E; Bucciarelli, M; Andreozzi, S; Salinetti, S; Sitzia, G; Bernacchia, R

    1999-01-01

    The disappearance of diphtheria and poliomyelitis is the best evidence of the efficacy of the vaccination strategies adopted in Italy. The active offer of the prophylaxis, reinforced by law, has characterised the operational aspects of the strategy. The active surveillance system is the main tool to take under control the effectiveness of health services responsible for vaccination. This system could be more easily implemented if the health services will be given a specific software aiming to handle and evaluate vaccination registers. The present pilot study, performed in the regions Marche and Sardegna, is an example of active surveillance and it is based on the ARVA software produced by the Istituto Superiore di Sanità. The results show a good level of coverage (> 95%) within the second year of life. Unsatisfactory results were obtained on the timing of vaccinations, as recommended by the vaccination schedule, mostly for the third doses.

  20. Helping the decision maker effectively promote various experts’ views into various optimal solutions to China’s institutional problem of health care provider selection through the organization of a pilot health care provider research system

    OpenAIRE

    Tang, Liyang

    2013-01-01

    Background The main aim of China’s Health Care System Reform was to help the decision maker find the optimal solution to China’s institutional problem of health care provider selection. A pilot health care provider research system was recently organized in China’s health care system, and it could efficiently collect the data for determining the optimal solution to China’s institutional problem of health care provider selection from various experts, then the purpose of this study was to apply ...

  1. Oral care practices for patients in Intensive Care Units: A pilot survey

    Directory of Open Access Journals (Sweden)

    Alexandre Franco Miranda

    2016-01-01

    Full Text Available Objective: To assess the level of knowledge and difficulties concerning hospitalized patients regarding preventive oral health measures among professionals working in Intensive Care Units (ICUs. Study Population and Methods: A cross-sectional survey was conducted among 71 health professionals working in the ICU. A self-administered questionnaire was used to determine the methods used, frequency, and attitude toward oral care provided to patients in Brazilian ICUs. The variables were analyzed using descriptive statistics (percentages. A one-sample t-test between proportions was used to assess significant differences between percentages. t-statistics were considered statistically significant for P < 0.05. Bonferroni correction was applied to account for multiple testing. Results: Most participants were nursing professionals (80.3% working 12-h shifts in the ICU (70.4%; about 87.3% and 66.2% reported having knowledge about coated tongue and nosocomial pneumonia, respectively (P < 0.05. Most reported using spatulas, gauze, and toothbrushes (49.3% or only toothbrushes (28.2% with 0.12% chlorhexidine (49.3% to sanitize the oral cavity of ICU patients (P < 0.01. Most professionals felt that adequate time was available to provide oral care to ICU patients and that oral care was a priority for mechanically ventilated patients (80.3% and 83.1%, respectively, P < 0.05. However, most professionals (56.4% reported feeling that the oral cavity was difficult to clean (P < 0.05. Conclusion: The survey results suggest that additional education is necessary to increase awareness among ICU professionals of the association between dental plaque and systemic conditions of patients, to standardize oral care protocols, and to promote the oral health of patients in ICUs.

  2. Piloting an advanced methodology to analyse health care policy networks: The example of Belgrade, Serbia

    Directory of Open Access Journals (Sweden)

    Helmut Wenzel

    2015-11-01

    Full Text Available Aim: Political decisions usually emerge from the competing interests of politicians, voters, and special interest groups. We investigated the applicability of an advanced methodological concept to determine whether certain institutional positions in a cooperating network have influence on the decision-making procedures. To that end, we made use of the institutional network of relevant health care and health governance institutions, concentrated in Belgrade, Serbia. Methods: We used a Principal Component Analysis (PCA based on a combination of measures for centrality in order to evaluate the positions of 25 players in Belgrade‟s institutional network. Their directed links were determined by a simulated position approach employing the authors‟ long-term involvement. Software packages used consisted of Visone 2.9, UCINET 6, and KeyPlayer 1.44. Results: In our analysis, the network density score in Belgrade was 71%. The PCA revealed two dimensions: control and attractiveness. The Ministry of Health exerted the highest level of control but displayed a low attractiveness in terms of receiving links from important players. The National Health Insurance Fund had less control capacity but a high attractiveness. The National Institute of Public Health‟s position was characterized by a low control capacity and high attractiveness, whereas the National Drug Agency, the National Health Council, and Non-Governmental Organisations were no prominent players. Conclusions: The advanced methodologies used here to analyse the health care policy network in Belgrade provided consistent results indicating that the intended decentralization of the health care network in Belgrade may be incomplete, still with low participation of civil society representatives. With the present study we set the stage for a broad-range survey based data collection applying the methodology piloted in Belgrade.

  3. 75 FR 80827 - Compliance Policy Guide; Radiofrequency Identification Feasibility Studies and Pilot Programs for...

    Science.gov (United States)

    2010-12-23

    ...; Radiofrequency Identification Feasibility Studies and Pilot Programs for Drugs; Notice To Extend Expiration Date...) Sec. 400.210 entitled ``Radiofrequency Identification (RFID) Feasibility Studies and Pilot Programs... ``Radiofrequency Identification (RFID) Feasibility Studies and Pilot Programs for Drugs.'' Previous extensions...

  4. Study of occupational stress among railway engine pilots

    Directory of Open Access Journals (Sweden)

    Devesh Kumar

    2011-01-01

    Full Text Available Background: Traffic volume and speed is going to be increased in Indian Railways successively, leading to higher stress in staff connected with train operations. The jobs of railway engine pilots come under the category of high-strain jobs, necessitating a need to conduct multicentric study to unfold the factors associated with occupational stress and organizational strategies. Materials and Methods: Present study covered 185 railway engine pilots and office clerks working in various railway zones by incidental method. Occupational Stress Index (OSI test developed by Srivastva and Singh, questionnaire of specific stressors constructed by authors and laboratory test battery for psychological screening of high-speed train pilots were used as tools. Results: Means of OSI and all the 12 occupational stressors of railway engine pilots were found significantly higher to that of office clerks. Means of OSI and occupational stressors of goods train pilots were significantly higher in comparison to high-speed train pilots and passenger train pilots. Study revealed positive correlation of speed perception and complex reaction time tests and negative correlation of other constituent tests of laboratory test battery to OSI test. Highest subgroup of stressor observedwas role overload followed by role conflict. Conclusions: These findings provide a prima facie evidence of higher occupational stress among railway engine pilots because of identified specific stressors prevalent in their job and explore the possible intervention strategies for its reduction. Significant correlation is noticed between OSI and laboratory test results, indicating its relevant utility in preliminary psychological screening.

  5. The DOE Water Cycle Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Miller, N.L.; King, A.W.; Miller, M.A.; Springer, E.P.; Wesely, M.L.; Bashford, K.E.; Conrad, M.E.; Costigan, K.; Foster, P.N.; Gibbs, H.K.; Jin, J.; Klazura, J.; Lesht, B.M.; Machavaram, M.V.; Pan, F.; Song, J.; Troyan, D.; Washington-Allen, R.A.

    2003-09-20

    A Department of Energy (DOE) multi-laboratory Water Cycle Pilot Study (WCPS) investigated components of the local water budget at the Walnut River Watershed in Kansas to study the relative importance of various processes and to determine the feasibility of observational water budget closure. An extensive database of local meteorological time series and land surface characteristics was compiled. Numerical simulations of water budget components were generated and, to the extent possible, validated for three nested domains within the Southern Great Plains; the DOE Atmospheric Radiation Measurement/Cloud Atmospheric Radiation Testbed (ARM/CART), the Walnut River Watershed (WRW), and the Whitewater Watershed (WW), Kansas A 2-month Intensive Observation Period (IOP) was conducted to gather detailed observations relevant to specific details of the water budget, including fine-scale precipitation, streamflow, and soil moisture measurements not made routinely by other programs. Event and season al water isotope (delta 18O, delta D) sampling in rainwater, streams, soils, lakes, and wells provided a means of tracing sources and sinks within and external to the WW, WRW, and the ARM/CART domains. The WCPS measured changes in leaf area index for several vegetation types, deep groundwater variations at two wells, and meteorological variables at a number of sites in the WRW. Additional activities of the WCPS include code development toward a regional climate model with water isotope processes, soil moisture transect measurements, and water level measurements in ground water wells.

  6. Pilot plant study for ethanol production

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J.S. [Korea Inst. of Science and Technology, Seoul (Korea, Republic of)

    1996-02-01

    Most of domestic alcohol fermentation factory adopt batch process of which productivity is lower than continuous fermentation process. They have made great effort to increase productivity by means of partial unit process automatization and process improvement with their accumulated experience but there is technical limitation in productivity of batch fermentation process. To produce and supply fuel alcohol, economic aspects must be considered first of all. Therefore, development of continuous fermentation process, of which productivity is high, is prerequisite to produce and use fuel alcohol but only a few foreign company possess continuous fermentation technic and use it in practical industrial scale fermentation. We constructed pilot plant (5 Stage CSTR 1 kl 99.5 v/v% ethanol/Day scale) to study some aspects stated below and our ultimate aims are production of industrial scale fuel alcohol and construction of the plant by ourselves. Some study concerned with energy saving separation and contamination control technic were entrusted to KAIST, A-ju university and KIST respectively. (author) 67 refs., 100 figs., 58 tabs.

  7. Informing efficient randomised controlled trials: exploration of challenges in developing progression criteria for internal pilot studies

    Science.gov (United States)

    Williamson, Paula R; Gamble, Carrol; O'Connell Francischetto, Elaine; Metcalfe, Chris; Davidson, Peter; Williams, Hywel; Blazeby, Jane M

    2017-01-01

    Objectives Designing studies with an internal pilot phase may optimise the use of pilot work to inform more efficient randomised controlled trials (RCTs). Careful selection of preagreed decision or ‘progression’ criteria at the juncture between the internal pilot and main trial phases provides a valuable opportunity to evaluate the likely success of the main trial and optimise its design or, if necessary, to make the decision not to proceed with the main trial. Guidance on the appropriate selection and application of progression criteria is, however, lacking. This paper outlines the key issues to consider in the optimal development and review of operational progression criteria for RCTs with an internal pilot phase. Design A structured literature review and exploration of stakeholders' opinions at a Medical Research Council (MRC) Hubs for Trials Methodology Research workshop. Key stakeholders included triallists, methodologists, statisticians and funders. Results There is considerable variation in the use of progression criteria for RCTs with an internal pilot phase, although 3 common issues predominate: trial recruitment, protocol adherence and outcome data. Detailed and systematic reporting around the decision-making process for stopping, amending or proceeding to a main trial is uncommon, which may hamper understanding in the research community about the appropriate and optimal use of RCTs with an internal pilot phase. 10 top tips for the development, use and reporting of progression criteria for internal pilot studies are presented. Conclusions Systematic and transparent reporting of the design, results and evaluation of internal pilot trials in the literature should be encouraged in order to facilitate understanding in the research community and to inform future trials. PMID:28213598

  8. LAM Pilot Study with Imatinib Mesylate (LAMP-1)

    Science.gov (United States)

    2015-10-01

    AD______________ AWARD NUMBER: W81XWH-14-1-0132 TITLE: LAM Pilot Study with Imatinib Mesylate ( LAMP -1) PRINCIPAL INVESTIGATOR: Charlie...AND SUBTITLE LAM Pilot Study with Imatinib Mesylate ( LAMP -1) 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0132 5c. PROGRAM ELEMENT...AVAILABILITY STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The LAMP -1 study is

  9. 1999 ANNUAL REPORT NATO/CCMS PILOT STUDY

    Science.gov (United States)

    This annual report present the proceedings of the second annual NATO/CCMS pilot study meeting in Belfast, UK in March 1999. Guest speakers focused on efforts in the research arena of clean products, clean processes, and pollution prevention tools.

  10. Pilot study of a multimodal intervention

    DEFF Research Database (Denmark)

    Jarden, Mary Ellen; Hovgaard, Doris; Boesen, Ellen

    2007-01-01

    Substantial physical and functional deconditioning and diminished psychological wellbeing are all potential adverse effects of allogeneic stem cell transplantation (allo-HSCT). The aim of this study was to evaluate the feasibility, safety and benefits (physical and functional capacity) of a 4......-6 week supervised and structured mixed-type exercise, progressive relaxation and psychoeducation programme in patients undergoing allo-HSCT. Nineteen patients were randomized to an intervention or a conventional care group (CC) and were tested for physical and functional capacity before admission...

  11. PILOT STUDY: CCQM-P32 pilot study. Anion calibration solutions

    Science.gov (United States)

    Weber, Michael; Wüthrich, Jürg

    2003-01-01

    In the CCQM-P32 pilot study two gravimetrically prepared anion calibration solutions of chloride and phosphate each of about 1 g/kg mass fraction were investigated. The comparison was an activity of the Inorganic Analysis Working Group of CCQM in 2002 and was piloted by the Swiss Federal Laboratories for Materials Testing and Research (EMPA). The following institutes participated in this study (in alphabetical order): BAM (Germany), CENAM (Mexico), EMPA (Switzerland), GUM (Poland), KRISS (South Korea), LNE (France), NIST (United States of America), NMIJ (Japan), NRCCRM (China), PTB (Germany), SMU (Slovakia). For the chloride calibration solution 11 participants provided 16 results by the following analytical techniques: coulometry (7), titrimetry (5) and ion chromatography (4). The phosphate amount content was determined by 9 NMIs and 11 results were reported. Phosphate ion chromatography was the most applied technique (4), followed by titrimetry (2), ICP-OES (2), gravimetry (1) and ion-exchange coulometry (1). All results were found within a range of +/-0.5% with respect to the gravimetric value. The variability (RSD) of the results is 0.13% for chloride and 0.26% for phosphate. The reported results of all participants are also graphically displayed in this report. Main text. To reach the main text of this paper, click on Final Report. The final report has been peer-reviewed and approved for publication by the CCQM Working Group on Inorganic Analysis, according to the provisions of the Mutual Recognition Arrangement (MRA).

  12. Ecological study of sleep disruption in PTSD: a pilot study.

    Science.gov (United States)

    Germain, Anne; Hall, Martica; Katherine Shear, M; Nofzinger, Eric A; Buysse, Daniel J

    2006-07-01

    Laboratory-based sleep studies have yielded inconsistent results regarding the presence and nature of objective sleep anomalies in posttraumatic stress disorder (PTSD). This pilot study aimed at assessing sleep in adult crime victims with PTSD by using in-home polysomnography. Compared to healthy archival subjects, PTSD subjects showed longer sleep latency, reduced total sleep time, and increased duration of nocturnal awakening. Quantitative electroencephalography (EEG) measures of delta and beta activity also differed in PTSD and healthy subjects. These preliminary findings suggest that ambulatory methods can capture objective signs of sleep disruption, and corroborate subjective complaints of disrupted sleep in PTSD.

  13. Music therapy as grief therapy for adults with mental illness and complicated grief: a pilot study.

    Science.gov (United States)

    Iliya, Yasmine A

    2015-01-01

    This randomized, controlled, mixed-methods pilot study examined the effectiveness and experiences of grief-specific music therapy, in addition to standard care, with adults (N=10) who have complicated grief (CG) and mental illness, as compared to standard care alone. The study tested Worden's (2009) theories of grief therapy as well as a new grief-specific music therapy intervention, based on Shear, Frank, Houck, and Reynolds' (2005) imaginal dialogue intervention and Austin's (2008) method of vocal psychotherapy. Results demonstrated that participants in the experimental group had a greater decrease of grief symptoms, as measured by the ICG-R, as compared with the control group.

  14. Developing spiritual and religious care competencies in practice: pilot of a Marie Curie blended learning event.

    Science.gov (United States)

    Smith, Tracy; Gordon, Tom

    2009-02-01

    The Marie Curie Cancer Care (2003) Spiritual and Religious Care Competencies for Specialist Palliative Care provide a common language for healthcare practitioners in the nebulous area of spiritual care. The development of a pilot blended learning event, as described in this paper, sought to integrate the competencies into practice by providing opportunities both online and in the classroom to explore this aspect of holistic care in depth. In the planning stages, multiprofessional focus groups determined the level of delivery, and emerging themes shaped the content. Self-awareness and reflection were key features and part of the overall process to improve competency. The features of the virtual learning environment (VLE) used were video, facilitated asynchronous discussion and direct links to key articles and documents, while interactive classroom activities built on prior learning. Evaluation covered all aspects of the course design from participant and facilitator perspectives. Participant comments were overwhelmingly positive in relation to the content and chosen delivery methods with concerns about online learning proving unfounded.

  15. Pilot Point-of-Care Ultrasound Curriculum at Harvard Medical School: Early Experience

    Science.gov (United States)

    Rempell, Joshua S.; Saldana, Fidencio; DiSalvo, Donald; Kumar, Navin; Stone, Michael B.; Chan, Wilma; Luz, Jennifer; Noble, Vicki E.; Liteplo, Andrew; Kimberly, Heidi; Kohler, Minna J.

    2016-01-01

    Introduction Point-of-care ultrasound (POCUS) is expanding across all medical specialties. As the benefits of US technology are becoming apparent, efforts to integrate US into pre-clinical medical education are growing. Our objective was to describe our process of integrating POCUS as an educational tool into the medical school curriculum and how such efforts are perceived by students. Methods This was a pilot study to introduce ultrasonography into the Harvard Medical School curriculum to first- and second-year medical students. Didactic and hands-on sessions were introduced to first-year students during gross anatomy and to second-year students in the physical exam course. Student-perceived attitudes, understanding, and knowledge of US, and its applications to learning the physical exam, were measured by a post-assessment survey. Results All first-year anatomy students (n=176) participated in small group hands-on US sessions. In the second-year physical diagnosis course, 38 students participated in four sessions. All students (91%) agreed or strongly agreed that additional US teaching should be incorporated throughout the four-year medical school curriculum. Conclusion POCUS can effectively be integrated into the existing medical school curriculum by using didactic and small group hands-on sessions. Medical students perceived US training as valuable in understanding human anatomy and in learning physical exam skills. This innovative program demonstrates US as an additional learning modality. Future goals include expanding on this work to incorporate US education into all four years of medical school. PMID:27833681

  16. Integration of midwives into the Quebec health care system. L'Equipe d'Evaluation des Projets-Pilotes Sages-Femmes.

    Science.gov (United States)

    Collin, J; Blais, R; White, D; Demers, A; Desbiens, F

    2000-01-01

    This paper reports on one aspect of the evaluation of the midwifery pilot projects in Quebec: the identification of the professional and organizational factors, as well as the mode of integrating midwives into the maternity care system, that would promote the best outcomes and the autonomy of midwives. The research strategy involved a multiple-case study, in which each midwifery pilot project represented a case. Based on a qualitative approach, the study employed various sources of data: individual interviews and focus groups with key informants, site observations and analyses of written documents. Results show that midwives were poorly integrated into the health care system during the evaluation. Four main reasons were identified: lack of knowledge about the practice of midwifery on the part of other health care providers; deficiencies in the legal and organizational structure of the pilot projects; competition over professional territories; and gaps between the midwives' and other providers' professional cultures. Recommendations are provided to facilitate the integration of midwives into the health care system.

  17. Using appreciative inquiry during care transitions: an exploratory study.

    Science.gov (United States)

    Scala, Elizabeth; Costa, Linda L

    2014-01-01

    The purpose of the study was to evaluate the effectiveness of a transitional care coaching intervention offered to chronically ill medical patients during the transition from hospital to home. This 2-arm randomized pilot study uses a coaching framework based on appreciative inquiry theory. This article reviews the appreciative inquiry literature and identifies the characteristics of patients who participated in appreciative inquiry coaching. Lessons learned are summarized, and suggestions for future research are offered.

  18. Diabetic Retinopathy Screening Using Telemedicine Tools: Pilot Study in Hungary

    Science.gov (United States)

    Eszes, Dóra J.; Szabó, Dóra J.; Russell, Greg; Kirby, Phil; Paulik, Edit; Nagymajtényi, László

    2016-01-01

    Introduction. Diabetic retinopathy (DR) is a sight-threatening complication of diabetes. Telemedicine tools can prevent blindness. We aimed to investigate the patients' satisfaction when using such tools (fundus camera examination) and the effect of demographic and socioeconomic factors on participation in screening. Methods. Pilot study involving fundus camera screening and self-administered questionnaire on participants' experience during fundus examination (comfort, reliability, and future interest in participation), as well as demographic and socioeconomic factors was performed on 89 patients with known diabetes in Csongrád County, a southeastern region of Hungary. Results. Thirty percent of the patients had never participated in any ophthalmological screening, while 25.7% had DR of some grade based upon a standard fundus camera examination and UK-based DR grading protocol (Spectra™ software). Large majority of the patients were satisfied with the screening and found it reliable and acceptable to undertake examination under pupil dilation; 67.3% were willing to undergo nonmydriatic fundus camera examination again. There was a statistically significant relationship between economic activity, education and marital status, and future interest in participation. Discussion. Participants found digital retinal screening to be reliable and satisfactory. Telemedicine can be a strong tool, supporting eye care professionals and allowing for faster and more comfortable DR screening. PMID:28078306

  19. Diabetic Retinopathy Screening Using Telemedicine Tools: Pilot Study in Hungary

    Directory of Open Access Journals (Sweden)

    Dóra J. Eszes

    2016-01-01

    Full Text Available Introduction. Diabetic retinopathy (DR is a sight-threatening complication of diabetes. Telemedicine tools can prevent blindness. We aimed to investigate the patients’ satisfaction when using such tools (fundus camera examination and the effect of demographic and socioeconomic factors on participation in screening. Methods. Pilot study involving fundus camera screening and self-administered questionnaire on participants’ experience during fundus examination (comfort, reliability, and future interest in participation, as well as demographic and socioeconomic factors was performed on 89 patients with known diabetes in Csongrád County, a southeastern region of Hungary. Results. Thirty percent of the patients had never participated in any ophthalmological screening, while 25.7% had DR of some grade based upon a standard fundus camera examination and UK-based DR grading protocol (Spectra™ software. Large majority of the patients were satisfied with the screening and found it reliable and acceptable to undertake examination under pupil dilation; 67.3% were willing to undergo nonmydriatic fundus camera examination again. There was a statistically significant relationship between economic activity, education and marital status, and future interest in participation. Discussion. Participants found digital retinal screening to be reliable and satisfactory. Telemedicine can be a strong tool, supporting eye care professionals and allowing for faster and more comfortable DR screening.

  20. Effects of Reiki on Pain, Anxiety, and Blood Pressure in Patients Undergoing Knee Replacement: A Pilot Study.

    Science.gov (United States)

    Baldwin, Ann Linda; Vitale, Anne; Brownell, Elise; Kryak, Elizabeth; Rand, William

    This blinded, controlled pilot study investigated the effects of Reiki on 46 patients undergoing knee replacement surgery. Of the 3 groups, Reiki, Sham Reiki, and Standard of Care, only the Reiki group showed significant reductions in pain, blood pressure, respiration rate, and state anxiety, which provides evidence for a full-scale clinical study.

  1. Isothermal dialysis to control intradialytic hypotension and patient comfort: a pilot study.

    Science.gov (United States)

    Li, Jianjun; Bellury, Lanell; Baird, Marianne; Van Brackle, Lewis N; Aduddell, Kathie

    2014-01-01

    Isothermal hemodialysis to improve intradialytic tolerance in hypotension-prone patients has been effective in outpatient settings. The purpose of this pilot study was to examine thermal control in an acute care setting and describe comfort issues associated with thermal control Although complaints of cold or shivering occurred more frequently with the isothermal hemodialysis group, cold discomfort was managed by nursing interventions and was not a cause of significant discomfort. No statistically significant difference was observed in blood pressure or patient's comfort level between standard and isothermal dialysis. However, isothermal hemodialysis may be an appropriate hemodialysis option for control of intradialytic hypotension in the acute care setting. Further research is recommended.

  2. Depression training in nursing homes: lessons learned from a pilot study.

    Science.gov (United States)

    Smith, Marianne; Stolder, Mary Ellen; Jaggers, Benjamin; Liu, Megan Fang; Haedtke, Chris

    2013-02-01

    Late-life depression is common among nursing home residents, but often is not addressed by nurses. Using a self-directed CD-based depression training program, this pilot study used mixed methods to assess feasibility issues, determine nurse perceptions of training, and evaluate depression-related outcomes among residents in usual care and training conditions. Of 58 nurses enrolled, 24 completed the training and gave it high ratings. Outcomes for 50 residents include statistically significant reductions in depression severity over time (p Depression training is an important vehicle to improve depression recognition and daily nursing care, but diverse factors must be addressed to assure optimal outcomes.

  3. Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit–acquired weakness: A pilot feasibility trial ☆ ☆☆

    OpenAIRE

    Connolly, Bronwen; Thompson, April; Douiri, Abdel; Moxham, John; Hart, Nicholas

    2015-01-01

    Purpose The aim of this study was to investigate feasibility of exercise-based rehabilitation delivered after hospital discharge in patients with intensive care unit–acquired weakness (ICU-AW). Materials and methods Twenty adult patients, mechanically ventilated for more than 48 hours, with ICU-AW diagnosis at ICU discharge were included in a pilot feasibility randomized controlled trial receiving a 16-session exercise-based rehabilitation program. Twenty-one patients without ICU-AW participa...

  4. Promoting childbirth companions in South Africa: a randomised pilot study

    Directory of Open Access Journals (Sweden)

    Smith Helen

    2007-04-01

    Full Text Available Abstract Background Most women delivering in South African State Maternity Hospitals do not have a childbirth companion; in addition, the quality of care could be better, and at times women are treated inhumanely. We piloted a multi-faceted intervention to encourage uptake of childbirth companions in state hospitals, and hypothesised that lay carers would improve the behaviour of health professionals. Methods We conducted a pilot randomised controlled trial of an intervention to promote childbirth companions in hospital deliveries. We promoted evidence-based information for maternity staff at 10 hospitals through access to the World Health Organization Reproductive Health Library (RHL, computer hardware and training to all ten hospitals. We surveyed 200 women at each site, measuring companionship, and indicators of good obstetric practice and humanity of care. Five hospitals were then randomly allocated to receive an educational intervention to promote childbirth companions, and we surveyed all hospitals again at eight months through a repeat survey of postnatal women. Changes in median values between intervention and control hospitals were examined. Results At baseline, the majority of hospitals did not allow a companion, or access to food or fluids. A third of women were given an episiotomy. Some women were shouted at (17.7%, N = 2085, and a few reported being slapped or struck (4.3%, N = 2080. Despite an initial positive response from staff to the childbirth companion intervention, we detected no difference between intervention and control hospitals in relation to whether a companion was allowed by nursing staff, good obstetric practice or humanity of care. Conclusion The quality and humanity of care in these state hospitals needs to improve. Introducing childbirth companions was more difficult than we anticipated, particularly in under-resourced health care systems with frequent staff changes. We were unable to determine whether the presence

  5. Mindfulness meditation in older adults with postherpetic neuralgia: a randomized controlled pilot study.

    Science.gov (United States)

    Meize-Grochowski, Robin; Shuster, George; Boursaw, Blake; DuVal, Michelle; Murray-Krezan, Cristina; Schrader, Ron; Smith, Bruce W; Herman, Carla J; Prasad, Arti

    2015-01-01

    This parallel-group, randomized controlled pilot study examined daily meditation in a diverse sample of older adults with postherpetic neuralgia. Block randomization was used to allocate participants to a treatment group (n = 13) or control group (n = 14). In addition to usual care, the treatment group practiced daily meditation for six weeks. All participants completed questionnaires at enrollment in the study, two weeks later, and six weeks after that, at the study's end. Participants recorded daily pain and fatigue levels in a diary, and treatment participants also noted meditation practice. Results at the 0.10 level indicated improvement in neuropathic, affective, and total pain scores for the treatment group, whereas affective pain worsened for the control group. Participants were able to adhere to the daily diary and meditation requirements in this feasibility pilot study.

  6. Interprofessional team building in the palliative home care setting: Use of a conceptual framework to inform a pilot evaluation.

    Science.gov (United States)

    Shaw, James; Kearney, Colleen; Glenns, Brenda; McKay, Sandra

    2016-01-01

    Home-based palliative care is increasingly dependent on interprofessional teams to deliver collaborative care that more adequately meets the needs of clients and families. The purpose of this pilot evaluation was to qualitatively explore the views of an interprofessional group of home care providers (occupational therapists, nurses, personal support work supervisors, community care coordinators, and a team coordinator) regarding a pilot project encouraging teamwork in interprofessional palliative home care services. We used qualitative methods, informed by an interprofessional conceptual framework, to analyse participants' accounts and provide recommendations regarding strategies for interprofessional team building in palliative home health care. Findings suggest that encouraging practitioners to share past experiences and foster common goals for palliative care are important elements of team building in interprofessional palliative care. Also, establishing a team leader who emphasises sharing power among team members and addressing the need for mutual emotional support may help to maximise interprofessional teamwork in palliative home care. These findings may be used to develop and test more comprehensive efforts to promote stronger interprofessional teamwork in palliative home health care delivery.

  7. Attitudes Toward Guarani and Spanish: A Pilot Study in Paraguay.

    Science.gov (United States)

    Rhodes, Nancy C.

    This study analyzes the language attitudes of the Paraguayan people toward their two languages, Guarani and Spanish. To study the bilingual situation in the South American country, a pilot survey was carried out in the capital city addressing the major topics of language attitudes, language usage, and language varieties. The goals of the survey…

  8. Self moving patients to the operation theatre - a pilot study

    DEFF Research Database (Denmark)

    Qvarfordh, Anna Pernilla; Rovsing, Marie Louise; Esbensen, Bente Appel

    2010-01-01

    The purpose of this pilot study was to investigate patients' satisfaction with walking to the operation theatre instead of being driven in a bed or wheel chair, and to identify the need for information. In total, 75 patients (aged 15-83 years) participated in the study. A questionnaire...

  9. Behavioral Activation for Depressed Teens: A Pilot Study

    Science.gov (United States)

    Ritschel, Lorie A.; Ramirez, Cynthia L.; Jones, Meredith; Craighead, W. Edward

    2011-01-01

    Behavioral activation (BA) is a psychosocial intervention that has shown promising treatment outcome results with depressed adults. The current pilot study evaluated a version of BA adapted for depressed adolescents. Six teens (3 male, 3 female, ages 14-17) who met criteria for major depressive disorder participated in the study. Participants were…

  10. Feasibility of Providing Culturally Relevant, Brief Interpersonal Psychotherapy for Antenatal Depression in an Obstetrics Clinic: A Pilot Study

    Science.gov (United States)

    Grote, Nancy K.; Bledsoe, Sarah E.; Swartz, Holly A.; Frank, Ellen

    2004-01-01

    Objective: To minimize barriers to care, ameliorate antenatal depression, and prevent postpartum depression, we conducted a pilot study to assess the feasibility of providing brief interpersonal psychotherapy (IPT-B) to depressed, pregnant patients on low incomes in an obstetrics and gynecological (OB/GYN) clinic. Method: Twelve pregnant,…

  11. A pilot study on peritraumatic dissociation and coping styles as risk factors for posttraumatic stress, anxiety and depression in parents after their child's unexpected admission to a Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Last Bob F

    2009-10-01

    Full Text Available Abstract Aim To study the prevalence of posttraumatic stress disorder (PTSD, anxiety and depression in parents three months after pediatric intensive care treatment of their child and examine if peritraumatic dissocation and coping styles are related to these mental health problems. Methods This is a prospective cohort study and included parents of children unexpectedly admitted to the Pediatric Intensive Care Unit (PICU from January 2006 to March 2007. At three months follow-up parents completed PTSD (n = 115, anxiety and depression (n = 128 questionnaires. Immediately after discharge, parents completed peritraumatic dissocation and coping questionnaires. Linear regression models with generalized estimating equations examined risk factors for mental health problems. Results Over 10% of the parents were likely to meet criteria for PTSD and almost one quarter for subclinical PTSD. Respectively 15% to 23% of the parents reported clinically significant levels of depression and anxiety. Peritraumatic dissocation was most strongly associated with PTSD, anxiety as well as depression. Avoidance coping was primarily associated with PTSD. Conclusion A significant number of parents have mental health problems three months after unexpected PICU treatment of their child. Improving detection and raise awareness of mental health problems is important to minimize the negative effect of these problems on parents' well-being.

  12. Evaluation of a Pilot Project to Introduce Simulation-Based Team Training to Pediatric Surgery Trauma Room Care

    Directory of Open Access Journals (Sweden)

    Markus Lehner

    2017-01-01

    Full Text Available Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings. Each scenario incorporated elements of pediatric trauma management as well as Crew Resource Management (CRM educational objectives. Participants completed anonymous pre- and postcourse questionnaires and rated the course itself as well as their own medical qualification and knowledge of CRM. Results. Participants found the course very realistic and selected scenarios highly relevant to their daily work. They reported a feeling of improved medical and nontechnical skills as well as no uncomfortable feeling during scenarios or debriefings. Conclusion. To our knowledge this pilot-project represents the first successful implementation of a simulation-based team-training course focused on pediatric trauma care in German-speaking countries with good acceptance.

  13. 78 FR 23941 - Pilot Program for Early Feasibility Study Investigational Device Exemption Applications...

    Science.gov (United States)

    2013-04-23

    ... HUMAN SERVICES Food and Drug Administration Pilot Program for Early Feasibility Study Investigational... the Early Feasibility Study Investigational Device Exemption (IDE) Applications pilot program to May 8... ``Investigational Device Exemptions (IDE) for Early Feasibility Medical Device Clinical Studies, Including...

  14. Skin and Plasma Autofluorescence During Hemodialysis : A Pilot Study

    NARCIS (Netherlands)

    Graaff, Reindert; Arsov, Stefan; Ramsauer, Bernd; Koetsier, Marten; Sundvall, Nils; Engels, Gerwin E.; Sikole, Aleksandar; Lundberg, Lennart; Rakhorst, Gerhard; Stegmayr, Bernd

    2014-01-01

    Skin autofluorescence (AF) is related to the accumulation of advanced glycation end products (AGEs) and is one of the strongest prognostic markers of mortality in hemodialysis (HD) patients. The aim of this pilot study was to investigate whether changes in skin AF appear after a single HD session an

  15. Emission studies from a CO2 capture pilot plant

    NARCIS (Netherlands)

    Silva, E.F. da; Kolderup, H.; Goetheer, E.L.V.; Hjarbo, K.W.; Huizinga, A.; Khakharia, P.M.; Tuinman, I.L.; Mejdell, T.; Zahlsen, K.; Vernstad, K.; Hyldbakk, A.; Holten, T.; Kvamsdal, H.M.; Os, P.J. van; Einbu, A.

    2013-01-01

    We report on a detailed study of emissions from a pilot-plant for CO2 capture at Maasvlakte (in the Netherlands). Three contributions to emissions were identified and analyzed: Gas phase emission, aerosols (also referred to as mist or fog) and droplets of entrained solvents. For the emission campaig

  16. Teaching Speech Communication with a Foreign Accent: A Pilot Study.

    Science.gov (United States)

    Chen, Guo-Ming; Chung, Jensen

    A pilot study examined problems encountered by foreign instructors teaching in American colleges. Fourteen Chinese-born instructors teaching in Speech Communication answered a questionnaire containing 12 open-ended questions. Recurring themes were coded from the answers, and then organized into three categories: cultural differences; linguistic…

  17. Consumer Understanding of Nutrition Marketing Terms: A Pilot Study

    Science.gov (United States)

    Haroldson, Amber; Yen, Chih-Lun

    2016-01-01

    The purpose of this pilot study was to examine the validity of a questionnaire developed to assess adult consumer understanding of nutrition marketing terms and the resulting impact on consumer behavior. Participants (n = 40) completed an electronic questionnaire. Efforts to establish validity and reliability suggest that the questionnaire is a…

  18. Assessing the Flipped Classroom in Operations Management: A Pilot Study

    Science.gov (United States)

    Prashar, Anupama

    2015-01-01

    The author delved into the results of a flipped classroom pilot conducted for an operations management course module. It assessed students' perception of a flipped learning environment after making them experience it in real time. The classroom environment was construed using a case research approach and students' perceptions were studied using…

  19. Development of the gagging problem assessment : A pilot study

    NARCIS (Netherlands)

    van den Heuvell, G. F. E. C. van Linden; Ter Pelkwijk, B. J.; Stegenga, B.

    2008-01-01

    An accepted management strategy for gagging problems appears not to exist. A reliable and valid instrument is needed to develop an evidence based treatment for this clinical problem. The aim of this pilot study was to evaluate the reliability and validity of a newly developed measurement tool for de

  20. The Effect of Background Music on Bullying: A Pilot Study

    Science.gov (United States)

    Ziv, Naomi; Dolev, Einat

    2013-01-01

    School bullying is a source of growing concern. A number of intervention programs emphasize the importance of a positive school climate in preventing bullying behavior. The aim of the presented pilot study was to examine whether calming background music, through its effect on arousal and mood, could create a pleasant atmosphere and reduce bullying…

  1. Tai Chi for People with Visual Impairments: A Pilot Study

    Science.gov (United States)

    Miszko, Tanya A.; Ramsey, Vincent K.; Blasch, Bruce B.

    2004-01-01

    This pilot study assessed the physical and psychological outcomes of a tai chi exercise program for eight adults with visual impairments. It found that after eight weeks of orientation and mobility training and tai chi practice, the participants' single leg-stance time and total knee flexion work and power improved, as did their frequency of,…

  2. Pasadena City College SIGI Project Research Design. Pilot Study.

    Science.gov (United States)

    Risser, John J.; Tulley, John E.

    A pilot study evaluation of SIGI (System of Interactive Guidance and Information) at Pasadena City College in 1974-75 tested the effectiveness of an experimental research design for an expanded field test of the system the following year. (SIGI is a computer based career guidance program designed by Educational Testing Service to assist community…

  3. VoIP for Telerehabilitation: A Pilot Usability Study for HIPAA Compliance

    Directory of Open Access Journals (Sweden)

    Valerie R. Watzlaf

    2012-06-01

    Full Text Available Consumer-based, free Voice and video over the Internet Protocol (VoIP software systems such as Skype and others are used by health care providers to deliver telerehabilitation and other health-related services to clients. Privacy and security applications as well as HIPAA compliance within these protocols have been questioned by practitioners, health information managers, and other healthcare entities. This pilot usability study examined whether four respondents who used the top three, free consumer-based, VoIP software systems perceived these VoIP technologies to be private, secure, and HIPAA compliant;  most did not.  While the pilot study limitations include the number of respondents and systems assessed, the protocol can be applied to future research and replicated for instructional purposes.  Recommendations are provided for VoIP companies, providers, and users. 

  4. Hypertension Education Intervention with Ugandan Nurses Working in Hospital Outpatient Clinic: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Godfrey Katende

    2014-01-01

    Full Text Available Noncommunicable diseases (NCDs pose a significant global burden in both developed and developing countries. It is estimated that, by 2025, 41.7% of males and 38.7% of females in Sub-Saharan Africa will develop high blood pressure (HBP. This is particularly true in Uganda with hypertensive prevalence rates estimated to range from 22.5% to 30.5%. Coupled with low levels of detection, treatment, and control, hypertension represents a Ugandan public health crisis. An innovative WHO-ISH education program culturally was adapted in a pilot study and focused on knowledge, skills, and attitudes (KSA of nurses caring for hypertensive patients in an outpatient clinic. Pre-post intervention data was collected and analyzed in which significant improvements were noted on all the three outcome measures. This pilot study demonstrated that nurses’ knowledge, skills, and attitudes could be significantly improved with a multimodal education program implemented in a low resource environment.

  5. Caregiver participation in hospice interdisciplinary team meetings via videophone technology: A pilot study to improve pain management.

    Science.gov (United States)

    Parker Oliver, Debra; Demiris, George; Wittenberg-Lyles, Elaine; Porock, Davina; Collier, Jacqueline; Arthur, Antony

    2010-11-01

    This article discusses a pilot study testing a videophone intervention enabling hospice patients and caregivers to remotely participate in interdisciplinary team meetings, with the goal of improving pain management. The aim of this study was to test potential outcome measures and combine the data with qualitative observations to assess the overall feasibility and promise of the intervention. The outcomes evaluated included hospice patient quality of life, caregiver perceptions of pain medications, caregiver quality of life, and caregiver anxiety related to team participation. The pilot study showed that caregiver participation in the care planning process is feasible and may change caregiver perceptions of pain medication, potentially improving pain management for hospice patients.

  6. A pilot training programme for health and social care professionals providing oncological and palliative care to lesbian, gay and bisexual patients in Ireland.

    LENUS (Irish Health Repository)

    Reygan, Finn C G

    2012-05-09

    OBJECTIVE: The international literature points to the specific cancer risks and palliative care needs of lesbian, gay and bisexual (LGB) populations. However, with the exception of a programme in the USA, there is a lack of training internationally for health and social care professionals providing oncological and palliative care to LGB patients. In Ireland, a training project funded by the Irish Cancer Society, the Irish Hospice Foundation and the Health Service Executive developed a training pilot programme for health and social care professionals providing oncological and palliative care to LGB patients. METHODS: Over 200 (N = 201) oncology and palliative care staff participated in 17 brief, 50-min trainings in pilot sites. Evaluation of the training included self-report questionnaires at the end of each training and an evaluation interview with one participant from each of the four sites. RESULTS: The majority of participants reported that they would recommend the training to their colleagues, were interested in further training in the area and found the training useful for their practice. They also reported becoming more familiar with LGB-related language and terminology, became more knowledgeable of LGB health issues and reported becoming more confident in providing care to LGB patients. CONCLUSIONS: Recommendations are that the training be made available across the health services in Ireland and included in postgraduate courses for trainee health and social care professionals. Copyright © 2012 John Wiley & Sons, Ltd.

  7. The pilot study of main care-givers' empowerment measurement%关于《主照护者自我潜力激活过程》量表的预试验

    Institute of Scientific and Technical Information of China (English)

    吴小玉; 森口育子

    2009-01-01

    Objective To check up the consistency of theoretic frame and practical data of "main care-givers,empewerment measurement" as well as its feasibility. Methods Through wide paper re-searching, the original theory "self- dependence" of China which based on the "empowerment" theory from the west was built up. Then a theoretic measurement sheet was made of which the theoretic reliability and contest reliability were both checked through multiple procedures. Finally the result was screened and puri-fied into 64 items. In this study, 120 main care- givers of in- patients over 65 years old were taken as the objects, and a pre-test with the 64-itemsheet. Results Empowerment measurement reliability was 0.89, 9 factors were all confirmed at factor analysis, cumulative contribution rate was 56.3%. Conclusions "Mea-surement of main care- givers' empewerment" is available, highly reliable and capable of application.%目的 检验"主照护者自我潜力激活过程量表"理论框架和实际数据的一致性并探讨其应用可行性.方法 通过阅读大量文献,对从欧美起源的"empowerment"概念和中国的"自力更生"进行概念分析基础上,提出了适合中国国情的"empowerment"理论,亦即定义为"自我潜力激活过程".由此做成理论量表方案,并经多个程序对其进行了理论和内容信度检验等,其结果 被筛选和精炼为64个项目.本次研究对象为65岁以上住院患者的主照护者120人,用此64项量表进行预试验.结果 "自我潜力激活过程"量表的Cronbach'α.信度为0.89.在效度检验中,因子分析9个因子被确认,累计贡献率56.3%.结论 "主照护者自我潜力激活过程"量表的信度和效度都得到了确认,有实用价值.

  8. Engaging primary healthcare nurses in men's health education: A pilot study.

    Science.gov (United States)

    Rizio, Taletha A; Thomas, Wendy J; O'Brien, Anthony Paul; Collins, Veronica; Holden, Carol A

    2016-03-01

    Many countries have identified a need for targeted men's health promotion within primary health care as part of broader men's health policy. Primary health care nurses are well placed to deliver such services but may lack the requisite skills. The aim of this study was to pilot the delivery phase of an education program and evaluate a train-the-trainer approach for delivering men's health education to primary health care nurses. The 8-h train-the-trainer workshop was designed to equip nurses to deliver men's health education workshops to peers. Surveys of facilitators (n = 18) and peer workshop participants (n = 98) evaluated their level of confidence in men's health and knowledge and skills in men's health promotion. After completing the train-the-trainer workshop, most facilitators expressed confidence (92%), and all indicated sufficient knowledge and access to resources to deliver a peer workshop. All agreed that the module was sufficiently flexible to suit their local setting. Following the peer education workshop, facilitators and workshop participants reported high levels of confidence and knowledge in men's health promotion. This pilot evaluation suggests train-the-trainer is an effective model to deliver men's health education across a range of settings, with a flexible approach to raising awareness and improving the skills of primary health care nurses in men's health promotion.

  9. SAĞLIK KURUMLARINDA AĞIZDAN AĞIZA PAZARLAMA VE BİR PİLOT ÇALIŞMA - WORD OF MOUTH MARKETING IN HEALTH CARE ORGANIZATIONS AND A PILOT STUDY

    Directory of Open Access Journals (Sweden)

    Beyza UZUNAL

    2010-07-01

    Full Text Available Özet:Sağlık hizmetleri kişilerin sağlığının korunması, teşhis,tedavi ve bakım için kişisel ve kurumsal olarak kamu veya özelşahısların vermiş olduğu hizmetler olarak tanımlanabilir.Sağlık hizmeti sunan kuruluşlarda pazarlamanın amacı;işletme amaçlarına uygun olarak hedef pazarın tatmindüzeyini geliştirerek, tüketicilerin beklentilerini karşılayandaha nitelikli hizmetleri sunmaktır.Günümüzde sağlık hizmetleri, profesyonel işletmecilikanlayışıyla şekillenmektedir. Artık sağlık yöneticilerininhedefleri arasında, daha çok hastayı çekerek gelen hastalarımemnun etmek ve hastanın tekrar aynı hastaneyi tercihetmesini sağlamak yer almaktadır.Ağızdan ağıza pazarlama ise güvene dayanan, tüketicilerinçevrelerindeki sosyal bağlantılarıyla ve diğer tüketicilerleürünler / hizmetler / markalar hakkındaki bilgi alışverişidir.Günümüzde tüketicilerin kendi aralarında bilgi vedeneyimlerini paylaşımı, geleneksel reklam ve pazarlamafaaliyetleriyle birlikte giderek artan bir öneme sahip olmayabaşlamıştır.Bu çalışmada genel anlamda ağızdan ağıza pazarlamanıntemel kavramları hakkında bilgi verilerek, sağlık sektöründeağızdan ağza pazarlamanın etkinliği anlaşılmaya çalışılmıştır.Abstract:Health care can be described as service personallyand institutionally by public or private operations in order todiagnosis, treatment and care the health of individuals. Aim ofmarketing in institutions offering health care to improve thelevel target market’s satisfaction and the institutions is toreach by presenting more qualified service to meet theexpectancy of consumersNowadays health care services are shaped by a professionalbusiness approach. Among the objectives of health caremanagers who take more satisfied patients by pulling them andthe patients prefer to allow a repetition of the same hospital islocated.Word of mouth marketing is basically sharing

  10. Pilot program to improve self-management of patients with heart failure by redesigning care coordination.

    Science.gov (United States)

    Shaw, Jessica D; O'Neal, Daniel J; Siddharthan, Kris; Neugaard, Britta I

    2014-01-01

    Objectives. We tested both an educational and a care coordination element of health care to examine if better disease-specific knowledge leads to successful self-management of heart failure (HF). Background. The high utilization of health care resources and poor patient outcomes associated with HF justify tests of change to improve self-management of HF. Methods. This prospective study tested two components of the Chronic Care Model (clinical information systems and self-management support) to improve outcomes in the self-management of HF among patients who received intensive education and care coordination during their acute care stay. A postdischarge follow-up phone call assessed their knowledge of HF self-management compared to usual care patients. Results. There were 20 patients each in the intervention and usual care groups. Intervention patients were more likely to have a scale at home, write down their weight, and practice new or different health behaviors. Conclusion. Patients receiving more intensive education knew more about their disease and were better able to self-manage their weight compared to patients receiving standard care.

  11. A Study of the Characteristics of Human-Pilot Control Response to Simulated Aircraft Lateral Motions

    Science.gov (United States)

    Cheatham, Donald C

    1954-01-01

    Report presents the results of studies made in an attempt to provide information on the control operations of the human pilot. These studies included an investigation of the ability of pilots to control simulated unstable yawing oscillations, a study of the basic characteristics of human-pilot control response, and a study to determine whether and to what extent pilot control response can be represented in an analytical form.

  12. 77 FR 74668 - Compliance Policy Guide; Radiofrequency Identification Feasibility Studies and Pilot Programs for...

    Science.gov (United States)

    2012-12-17

    ... Feasibility Studies and Pilot Programs for Drugs; Notice To Extend Expiration Date AGENCY: Food and Drug... ``Radiofrequency Identification (RFID) Feasibility Studies and Pilot Programs for Drugs'' to December 31, 2014. FOR... (RFID) Feasibility Studies and Pilot Programs for Drugs.'' Previous extensions of the expiration date...

  13. Structural differences in gray matter between glider pilots and non-pilots. A voxel based morphometry study.

    Directory of Open Access Journals (Sweden)

    Tosif eAhamed

    2014-11-01

    Full Text Available Glider flying is a unique skill that requires pilots to control an aircraft at high speeds in three dimensions and amidst frequent full body rotations. In the present study we investigated the neural correlates of flying a glider using voxel-based morphometry (VBM. The comparison between gray matter densities of 15 glider pilots and a control group of 15 non-pilots exhibited significant gray matter density increases in left ventral premotor cortex, anterior cingulate cortex and the supplementary eye field. We posit that the identified regions might be associated with cognitive and motor processes related to flying such as joystick control, visuo-vestibular interaction and oculomotor control.

  14. The Systematic Development and Pilot Randomized Evaluation of Counselling for Alcohol Problems, a Lay Counselor‐Delivered Psychological Treatment for Harmful Drinking in Primary Care in India: The PREMIUM Study

    OpenAIRE

    2015-01-01

    BACKGROUND: Despite harmful drinking causing a significant burden on global health, there is a large treatment gap, especially in low- and middle-income countries. A major barrier to care is the lack of adequately skilled human resources to deliver contextually appropriate treatments. This paper describes the systematic process used to develop Counselling for Alcohol Problems (CAP), a brief psychological treatment (PT) for delivery by lay counselors in routine primary care settings to men wit...

  15. A single blinded randomised controlled pilot trial of prism adaptation for improving self-care in stroke patients with neglect.

    Science.gov (United States)

    Turton, Ailie J; O'Leary, Kelly; Gabb, Judith; Woodward, Rebecca; Gilchrist, Iain D

    2010-04-01

    Prism adaptation has been shown to alleviate the symptoms of unilateral spatial neglect following stroke in single case and small group studies. The purposes of this single blinded pilot randomised controlled trial were to determine the feasibility of delivering prism adaptation treatment in a clinically valid sample and to assess its impact on self-care. Thirty seven right hemisphere stroke patients with unilateral spatial neglect were randomised into either prism adaptation (using 10 dioptre, 6 degree prisms) or sham treatment (using plain glasses) groups. Treatment was delivered each weekday for two weeks. Pointing accuracy, without vision of the finger, was recorded each day before treatment. Outcome was measured, by blinded assessors, four days and eight weeks after the end of treatment using the Catherine Bergego Scale (CBS) and the conventional neuropsychological tests from the Behavioural Inattention Test (BIT). Thirty four patients received treatment: 16 with prisms, 18 sham. Mean compliance was 99% and 97%, respectively. Over the treatment days only the prism treated group showed increased leftward bias in open loop pointing to targets on a touch screen. However, despite the group level changes in pointing behaviour no overall effect of the treatment on self-care or BIT were found.

  16. Developing a Web-Based Nursing Practice and Research Information Management System: A Pilot Study.

    Science.gov (United States)

    Choi, Jeeyae; Lapp, Cathi; Hagle, Mary E

    2015-09-01

    Many hospital information systems have been developed and implemented to collect clinical data from the bedside and have used the information to improve patient care. Because of a growing awareness that the use of clinical information improves quality of care and patient outcomes, measuring tools (electronic and paper based) have been developed, but most of them require multiple steps of data collection and analysis. This necessitated the development of a Web-based Nursing Practice and Research Information Management System that processes clinical nursing data to measure nurses' delivery of care and its impact on patient outcomes and provides useful information to clinicians, administrators, researchers, and policy makers at the point of care. This pilot study developed a computer algorithm based on a falls prevention protocol and programmed the prototype Web-based Nursing Practice and Research Information Management System. It successfully measured performance of nursing care delivered and its impact on patient outcomes successfully using clinical nursing data from the study site. Although Nursing Practice and Research Information Management System was tested with small data sets, results of study revealed that it has the potential to measure nurses' delivery of care and its impact on patient outcomes, while pinpointing components of nursing process in need of improvement.

  17. A pilot randomized trial of technology-assisted goal setting to improve physical activity among primary care patients with prediabetes.

    Science.gov (United States)

    Mann, Devin M; Palmisano, Joseph; Lin, Jenny J

    2016-12-01

    Lifestyle behavior changes can prevent progression of prediabetes to diabetes but providers often are not able to effectively counsel about preventive lifestyle changes. We developed and pilot tested the Avoiding Diabetes Thru Action Plan Targeting (ADAPT) program to enhance primary care providers' counseling about behavior change for patients with prediabetes. Primary care providers in two urban academic practices and their patients with prediabetes were recruited to participate in the ADAPT study, an unblinded randomized pragmatic trial to test the effectiveness of the ADAPT program, including a streamlined electronic medical record-based goal setting tool. Providers were randomized to intervention or control arms; eligible patients whose providers were in the intervention arm received the ADAPT program. Physical activity (the primary outcome) was measured using pedometers, and data were gathered about patients' diet, weight and glycemic control. A total of 54 patients were randomized and analyzed as part of the 6-month ADAPT study (2010-2012, New York, NY). Those in the intervention group showed an increase total daily steps compared to those in the control group (+ 1418 vs - 598, p = 0.007) at 6 months. There was also a trend towards weight loss in the intervention compared to the control group (- 1.0 lbs. vs. 3.0 lbs., p = 0.11), although no change in glycemic control. The ADAPT study is among the first to use standard electronic medical record tools to embed goal setting into realistic primary care workflows and to demonstrate a significant improvement in prediabetes patients' physical activity.

  18. Strategies For Integrating STEM Content: A Pilot Case Study

    OpenAIRE

    Figliano, Fred Joseph

    2007-01-01

    The goal of this study was to identify strategies used by exemplar practitioners to develop integrated instruction. A pilot case study design was used and four sources of data were analyzed allowing for a convergence of data sets. These data sets included a questionnaire, an audio recording, lesson plans, and student artifacts. Data were analyzed through theme analysis producing 26 strategies. These strategies were then collapsed into a final list of 15 representing important areas of conside...

  19. Pilot study of smoking, alcohol and drug abuse prevention.

    Science.gov (United States)

    McAlister, A; Perry, C; Killen, J; Slinkard, L A; Maccoby, N

    1980-07-01

    A longitudinal pilot study gathered data on the onset and prevention of smoking, alcohol, and drug abuse among 526 students from two junior-high-schools in California. Over two school years, students who were trained to resist social pressures toward tobacco, alcohol, and drug use began smoking at less than one-half the rate of those who did not receive special training. Frequent alcohol and marijuana use was also less prevalent among the students who received such training.

  20. A Pilot Study on EFL Reading Teaching through Linguistic Landscape

    Institute of Scientific and Technical Information of China (English)

    CHEN Yuan

    2015-01-01

    The public displays of languages have been described as “linguistic landscape”. Nowadays, most globalized cities have worked hard at creating English-friendly environments by including bilingual signs to facilitate communication. The domain of linguistic landscape, therefore, has drawn the interests of English educators. This paper serves as a pilot study to exploit every possibility in the linguistic landscape as EFL teaching material, and optimize pedagogic activities in reading classes by adopting this linguistic resource.

  1. CE: Defining and Understanding Pilot and Other Feasibility Studies.

    Science.gov (United States)

    Morris, Nancy S; Rosenbloom, Deborah A

    2017-03-01

    : Nurses are becoming increasingly involved in conducting clinical research in which feasibility studies are often the first steps. Understanding why and how these studies are conducted may encourage clinical nurses to engage with researchers and take advantage of opportunities to participate in advancing nursing science. This article provides an overview of feasibility studies, including pilot studies, and explains the type of preliminary data they seek to provide in order to make larger, future studies more efficient and successful. By way of example, the authors discuss a feasibility study they conducted that illustrates the key components and necessary steps involved in such work.

  2. Estudio piloto sobre el manejo de la fluidoterapia intravenosa en pacientes adultos de un hospital de tercer nivel Pilot study of intravenous fluid therapy management in adult patients at a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    A. M.ª Cordero Cruz

    2012-06-01

    édicos internistas los que consiguieron una mayor puntuación (p = 0,014. Se encontraron también diferencias aunque no significativas en actitud personal (p= 0,162. Los conocimientos sobre fluidoterapia intravenosa aumentan con los años de experiencia clínica (coeficiente de correlación de Spearman = 0,386, p = 0,047. Conclusiones: Los profesionales que prescriben la FTI perciben la necesidad de diseñar programas de formación en FTI, junto con la elaboración de guías y protocolos consensuados.The purpose of intravenous fluid therapy (IFT is to maintain or restore internal equilibrium by administering fluids and/or different electrolyte components. Its correct use and the prevention of complications arising from their misuse depend on the knowledge of the medical team on this subject. We analyzed this issue in different clinical areas of a tertiary hospital. Material and methods: We performed a descriptive cross-sectional pilot study via a questionnaire given to physicians specializing in internal medicine (IM and digestive system surgery (SDS who perform clinical practice in hospital units with unit dose drug dispensing system. We designed an anonymous questionnaire with 25 questions relative to knowledge of theory and practices, as well as the opinion of physicians regarding IFT. We evaluated the association between nominal qualitative variables with the Chi-square or Fisher's exact test. The behavior of the quantitative variables was assessed using the t-student test. The analysis of the data was generated using SAS/STAT, Version 9. Results: 28 questionnaires were collected from 13 surgeons and 15 digestive interns. Over 40% of specialists considered further education in IFT a necessity , especially regarding its prescription (SDS: 61.54%, IM: 71.43%. No statistically significant differences were found between the specialties in terms of perceived frequency of complications associated with IFT or in the frequency indication with the exception of hypovolemic shock, which is

  3. An Educational Intervention to Train Professional Nurses in Promoting Patient Engagement: A Pilot Feasibility Study

    Science.gov (United States)

    Barello, Serena; Graffigna, Guendalina; Pitacco, Giuliana; Mislej, Maila; Cortale, Maurizio; Provenzi, Livio

    2017-01-01

    Introduction: Growing evidence recognizes that patients who are motivated to take an active role in their care can experience a range of health benefits and reduced healthcare costs. Nurses play a critical role in the effort to make patients fully engaged in their disease management. Trainings devoted to increase nurses' skills and knowledge to assess and promote patient engagement are today a medical education priority. To address this goal, we developed a program of nurse education training in patient engagement strategies (NET-PES). This paper presents pilot feasibility study and preliminary participants outcomes for NET-PES. Methods: This is a pilot feasibility study of a 2-session program on patient engagement designed to improve professional nurses' ability to engage chronic patients in their medical journey; the training mainly focused on passing patient engagement assessment skills to clinicians as a crucial mean to improve care experience. A pre-post pilot evaluation of NET-PES included 46 nurses working with chronic conditions. A course specific competence test has been developed and validated to measure patient engagement skills. The design included self-report questionnaire completed before and after the training for evaluation purposes. Participants met in a large group for didactic presentations and then they were split into small groups in which they used role-play and case discussion to reflect upon the value of patient engagement measurement in relation to difficult cases from own practice. Results: Forty-six nurses participated in the training program. The satisfaction questionnaire showed that the program met the educational objectives and was considered to be useful and relevant by the participants. Results demonstrated changes on clinicians' attitudes and skills in promoting engagement. Moreover, practitioners demonstrated increases on confidence regarding their ability to support their patients' engagement in the care process. Conclusions

  4. Low-Cost Radon Reduction Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Rose, William B. [Partnership for Advanced Residential Retrofit, Champaign, IL (United States); Francisco, Paul W. [Partnership for Advanced Residential Retrofit, Champaign, IL (United States); Merrin, Zachary [Partnership for Advanced Residential Retrofit, Champaign, IL (United States)

    2015-09-01

    The aim of the research was to conduct a primary scoping study on the impact of air sealing between the foundation and the living space on radon transport reduction across the foundation-living space floor assembly. Fifteen homes in the Champaign, Illinois area participated in the study. These homes were instrumented for hourly continuous radon measurements and simultaneous temperature and humidity the foundation was improved. However, this improved isolation did not lead to significant reductions in radon concentration in the living space. Other factors such as outdoor temperature were shown to have an impact on radon concentration.

  5. Motivation in the Classroom: A Pilot Study.

    Science.gov (United States)

    Schilling, Deanna E.

    Purposes of this study were to (1) investigate the validity of Maslow's Hierarchy of Needs as it applies to young children; (2) determine developmental shifts in expressed motivational needs; (3) gather information concerning the worries and fears of young children, particularly those of low socioeconomic status; and (4) gather data regarding…

  6. Low-cost Radon Reduction Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Rose, William B. [Univ. of Illinois, Urbana-Champaign, IL (United States); Francisco, Paul W. [Univ. of Illinois, Urbana-Champaign, IL (United States); Merrin, Zachary [Univ. of Illinois, Urbana-Champaign, IL (United States)

    2015-09-01

    The U.S. Department of Energy's Building America research team Partnership for Advanced Residential Retrofits conducted a primary scoping study on the impact of air sealing between the foundation and the living space on radon transport reduction across the foundation and living space floor assembly. Fifteen homes in the Champaign, Illinois, area participated in the study. These homes were instrumented for hourly continuous radon measurements and simultaneous temperature and humidity measurements. Blower door and zone pressure diagnostics were conducted at each house. The treatments consisted of using air-sealing foams at the underside of the floor that separated the living space from the foundation and providing duct sealing on the ductwork that is situated in the foundation area. The hypothesis was that air sealing the floor system that separated the foundation from the living space should better isolate the living space from the foundation; this isolation should lead to less radon entering the living space from the foundation. If the hypothesis had been proven, retrofit energy-efficiency programs may have chosen to adopt these isolation methods for enhanced radon protection to the living space.

  7. High-Resolution Scintimammography: A Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Rachel F. Brem; Joelle M. Schoonjans; Douglas A. Kieper; Stan Majewski; Steven Goodman; Cahid Civelek

    2002-07-01

    This study evaluated a novel high-resolution breast-specific gamma camera (HRBGC) for the detection of suggestive breast lesions. Methods: Fifty patients (with 58 breast lesions) for whom a scintimammogram was clinically indicated were prospectively evaluated with a general-purpose gamma camera and a novel HRBGC prototype. The results of conventional and high-resolution nuclear studies were prospectively classified as negative (normal or benign) or positive (suggestive or malignant) by 2 radiologists who were unaware of the mammographic and histologic results. All of the included lesions were confirmed by pathology. Results: There were 30 benign and 28 malignant lesions. The sensitivity for detection of breast cancer was 64.3% (18/28) with the conventional camera and 78.6% (22/28) with the HRBGC. The specificity with both systems was 93.3% (28/30). For the 18 nonpalpable lesions, sensitivity was 55.5% (10/18) and 72.2% (13/18) with the general-purpose camera and the HRBGC, respectively. For lesions 1 cm, 7 of 15 were detected with the general-purpose camera and 10 of 15 with the HRBGC. Four lesions (median size, 8.5 mm) were detected only with the HRBGC and were missed by the conventional camera. Conclusion: Evaluation of indeterminate breast lesions with an HRBGC results in improved sensitivity for the detection of cancer, with greater improvement shown for nonpalpable and 1-cm lesions.

  8. Treadmill Desks at LANL - Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Fellows, Samara Kia [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-07-28

    It is well established that sedentariness is the largest, preventable contributor to premature death, eclipsing smoking in recent years. One approach to reduce sedentariness is by using a treadmill desk to perform office work while walking at a low speed.We found an increased interest level when the treadmill desks were first introduced to LANL, but after a few months interest appeared to drop. It is possible that treadmill desk use was occurring, but subjects did not record their use. The treadmill desks will not be readily available for purchase by employees due to the study outcome. Additionally, conclusive changes in body measurements could not be performed due to lack of follow up by 58% of the participants.

  9. Evaluation of the preliminary effectiveness of hand massage therapy on postoperative pain of adults in the intensive care unit after cardiac surgery: a pilot randomized controlled trial.

    Science.gov (United States)

    Boitor, Mădălina; Martorella, Géraldine; Arbour, Caroline; Michaud, Cécile; Gélinas, Céline

    2015-06-01

    Although many intensive care unit patients experience significant pain, very few studies explored massage to maximize their pain relief. This study aimed to evaluate the preliminary effects of hand massage on pain after cardiac surgery in the adult intensive care unit. A pilot randomized controlled trial was used for this study. The study was conducted in a Canadian medical-surgical intensive care unit. Forty adults who were admitted to the intensive care unit after undergoing elective cardiac surgery in the previous 24 hours participated in the study. They were randomly assigned to the experimental (n = 21) or control (n = 19) group. The experimental group received a 15-minute hand massage, and the control group received a 15-minute hand-holding without massage. In both groups the intervention was followed by a 30-minute rest period. The interventions were offered on 2-3 occasions within 24 hours after surgery. Pain, muscle tension, and vital signs were assessed. Pain intensity and behavioral scores were decreased for the experimental group. Although hand massage decreased muscle tension, fluctuations in vital signs were not significant. This study supports potential benefits of hand massage for intensive care unit postoperative pain management. Although larger randomized controlled trials are necessary, this low-cost nonpharmacologic intervention can be safely administered.

  10. SERDP munition disposal source characterization pilot study

    Energy Technology Data Exchange (ETDEWEB)

    McCallen, R.C.; Couch, R.G.; Fried, L.E. [and others

    1995-09-01

    The Strategic Environmental Research and Development Program (SERDP) is supporting studies to develop and implement technologies for the safe, efficient, and environmentally sound disposal of obsolete munitions and propellants which are stored at various locations across the country. One proposed disposal technique is the open-air burning or detonation (OB/OD) of this material. Although OB/OD is viewed as an efficient and cost-effective method for reducing the inventory of unwanted munitions and propellants, questions regarding its safety and environmental impacts must be addressed. Since very large amounts of munitions and propellants must be consumed inexpensively in relatively short time periods and with the very restrictive Federal and State regulations on environmental issues, it is clear that traditional OB/OD procedures will not be acceptable and that it is necessary to develop modified or advanced OB/OD technology. The effectiveness and environmental impact of the OB/OD technology must be verified by experimental data and with validated numerical models for acceptance by Federal and State regulators. Specifically, technology must be developed and tested that minimizes toxic bum and detonation products the noise (peak pressure) and destructive effect (impulse) of the explosive blast generation and travel distance of shrapnel, and entrainment of dust. Three explosion attenuation scenarios are analyzed: Contained water, aqueous foams, and wet sand.

  11. Telemedicine and Plastic Surgery: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Denis Souto Valente

    2015-01-01

    Full Text Available Background. Telemedicine can be defined as the use of electronic media for transmission of information and medical data from one site to another. The objective of this study is to demonstrate an experience of telemedicine in plastic surgery. Methods. 32 plastic surgeons received a link with password for real-time streaming of a surgery. At the end of the procedure, the surgeons attending the procedure by the Internet answered five questions. The results were analyzed with descriptive statistics. Results. 27 plastic surgeons attended the online procedure in real-time. 96.3% considered the access to the website as good or excellent and 3.7% considered it bad. 14.8% reported that the transmission was bad and 85.2% considered the quality of transmission as good or excellent. 96.3% classified the live broadcasting as a good or excellent learning experience and 3.7% considered it a bad experience. 92.6% reported feeling able to perform this surgery after watching the demo and 7.4% did not feel able. 100% of participants said they would like to participate in other surgical demonstrations over the Internet. Conclusion. We conclude that the use of telemedicine can provide more access to education and medical research, for plastic surgeons looking for medical education from distant regions.

  12. Preliminary Hydrogeologic Characterization Results from the Wallula Basalt Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    B.P. McGrail; E. C. Sullivan; F. A. Spane; D. H. Bacon; G. Hund; P. D. Thorne; C. J. Thompson; S. P. Reidel; F. S. Colwell

    2009-12-01

    The DOE's Big Sky Regional Carbon Sequestration Partnership has completed drilling the first continental flood basalt sequestration pilot borehole to a total depth (TD) of 4,110 feet on the Boise White Paper Mill property at Wallula, Washington. Site suitability was assessed prior to drilling by the 2007-2008 acquisition, processing and analysis of a four-mile, five-line three component seismic swath, which was processed as a single data-dense line. Analysis of the seismic survey data indicated a composite basalt formation thickness of {approx}8,000 feet and absence of major geologic structures (i.e., faults) along the line imaged by the seismic swath. Drilling of Wallula pilot borehole was initiated on January 13, 2009 and reached TD on April 6, 2009. Based on characterization results obtained during drilling, three basalt breccia zones were identified between the depth interval of 2,716 and 2,910 feet, as being suitable injection reservoir for a subsequent CO2 injection pilot study. The targeted injection reservoir lies stratigraphically below the massive Umtanum Member of the Grande Ronde Basalt, whose flow-interior section possesses regionally recognized low-permeability characteristics. The identified composite injection zone reservoir provides a unique and attractive opportunity to scientifically study the reservoir behavior of three inter-connected reservoir intervals below primary and secondary caprock confining zones. Drill cuttings, wireline geophysical logs, and 31one-inch diameter rotary sidewall cores provided geologic data for characterization of rock properties. XRF analyses of selected rock samples provided geochemical characterizations of the rocks and stratigraphic control for the basalt flows encountered by the Wallula pilot borehole. Based on the geochemical results, the pilot borehole was terminated in the Wapshilla Ridge 1 flow of the Grande Ronde Basalt Formation. Detailed hydrologic test characterizations of 12 basalt interflow

  13. Medication coaching program for patients with minor stroke or TIA: A pilot study

    Directory of Open Access Journals (Sweden)

    Sides Elizabeth G

    2012-07-01

    Full Text Available Abstract Background Patients who are hospitalized with a first or recurrent stroke often are discharged with new medications or adjustment to the doses of pre-admission medications, which can be confusing and pose safety issues if misunderstood. The purpose of this pilot study was to assess the feasibility of medication coaching via telephone after discharge in patients with stroke. Methods Two-arm pilot study of a medication coaching program with 30 patients (20 intervention, 10 control. Consecutive patients admitted with stroke or TIA with at least 2 medications changed between admission and discharge were included. The medication coach contacted intervention arm patients post-discharge via phone call to discuss risk factors, review medications and triage patients’ questions to a stroke nurse and/or pharmacist. Intervention and control participants were contacted at 3 months for outcomes. The main outcomes were feasibility (appropriateness of script, ability to reach participants, and provide requested information and participant evaluation of medication coaching. Results The median lengths of the coaching and follow-up calls with requested answers to these questions were 27 minutes and 12 minutes, respectively, and participant evaluations of the coaching were positive. The intervention participants were more likely to have seen their primary care provider than were control participants by 3 months post discharge. Conclusions This medication coaching study executed early after discharge demonstrated feasibility of coaching and educating stroke patients with a trained coach. Results from our small pilot showed a possible trend towards improved appointment-keeping with primary care providers in those who received coaching.

  14. Patient Navigation for Mothers with Depression who Have Children in Head Start: A Pilot Study.

    Science.gov (United States)

    Diaz-Linhart, Yaminette; Silverstein, Michael; Grote, Nancy; Cadena, Lynn; Feinberg, Emily; Ruth, Betty J; Cabral, Howard

    2016-10-01

    This study assesses the potential of social work-facilitated patient navigation to help mothers with depression engage with mental health care. We conducted a randomized pilot trial (N = 47) in Head Start-a U.S. preschool program for low-income children. Seven lay navigators received training and supervision from professional social workers. After 6 months, more navigated participants engaged with a psychologist, therapist, or social worker (45% vs. 13%, 95% confidence interval [CI] [2, 57]); engaged with any provider, (55% vs. 26%, 95% CI [1, 56]); and reported having a "depression care provider" (80% vs. 41%, 95% CI [9, 65]). Community-based navigation appears feasible; however, more definitive testing is necessary.

  15. A Needs Assessment of Health Issues Related to Maternal Mortality Rates in Afghanistan: A Pilot Study.

    Science.gov (United States)

    Naim, Ali; Feldman, Robert; Sawyer, Robin

    2015-01-01

    Maternal death rates in Afghanistan were among the highest in the world during the reign of the Taliban. Although these figures have improved, current rates are still alarming. The aim of this pilot study was to develop a needs assessment of the major health issues related to the high maternal mortality rates in Afghanistan. In-depth interviews were conducted with managerial midwives, clinical midwives, and mothers. Results of the interviews indicate that the improvement in the maternal mortality rate may be attributed to the increase in the involvement of midwives in the birthing process. However, barriers to decreasing maternal mortality still exist. These include transportation, access to care, and sociocultural factors such as the influence of the husband and mother-in-law in preventing access to midwives. Therefore, any programs to decrease maternal mortality need to address infrastructure issues (making health care more accessible) and sociocultural factors (including husbands and mother-in-laws in maternal health education). However, it should be noted that these findings are based on a small pilot study to help develop a larger scale need assessment.

  16. A Pilot Study of Immune and Mood Outcomes of a Community-Based Intervention for Dementia Caregivers: The PLST Intervention

    OpenAIRE

    Garand, Linda; Buckwalter, Kathleen C.; Lubaroff, David M.; Tripp-Reimer, Toni; Frantz, Rita A.; Ansley, Timothy N.

    2002-01-01

    Providing care to a family member with dementia is conceptualized as a chronic stressor with adverse psychological and physical effects. The purpose of this pilot study was to evaluate mood and immune outcomes of caregivers exposed to a community-based psychoeducational nursing intervention based on the Progressively Lowered Stress Threshold (PLST) model. The PLST intervention is designed to strengthen the psychological resources of dementia caregivers by teaching methods of preventing and/or...

  17. Facial recognition and laser surface scan: a pilot study

    DEFF Research Database (Denmark)

    Lynnerup, Niels; Clausen, Maja-Lisa; Kristoffersen, Agnethe May

    2009-01-01

    that the discriminatory value was 86.7%. We also tested the surface scanner in terms of reliability in establishing point measures on skulls, and compared with physical measurements performed by calipers. The variation was on average 1 mm for five cranial measures. We suggest how surface scanning might be applied......Surface scanning of the face of a suspect is presented as a way to better match the facial features with those of a perpetrator from CCTV footage. We performed a simple pilot study where we obtained facial surface scans of volunteers and then in blind trials tried to match these scans with 2D...

  18. Nursing Students' Clinical Experience With Death: A Pilot Study.

    Science.gov (United States)

    Heise, Barbara A; Gilpin, Laura C

    2016-01-01

    Although debriefing in simulation settings is routine in nursing education, debriefing does not routinely take place in clinical settings with nursing students after a patient has died. This pilot study sought to explore nursing students' perceptions of their first experience with the death of a patient. Students reported emotional distress and feelings of inadequacy with regard to communicating with and supporting the family of the dying patient. Only half the students sampled reported debriefing by their clinical instructor or staff. Nurse educators must include debriefing and student support following a patient death in the clinical setting.

  19. Indonesian EFL Students’ Perspective on Writing Process: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Imelda Hermilinda Abas

    2016-06-01

    Full Text Available The study was aimed at understanding the EFL Indonesian students’ perspective on the writing process. The pilot study involved two male Indonesian postgraduate students in Universiti Utara Malaysia. The Indonesian students were selected based on the following criteria: (1 had enough knowledge in English writing, indicated by the completion of Academic Writing and Research Methodology courses taken in UUM; (2 had written an unpublished thesis during their undergraduate studies in Indonesia and they are writing their master or doctoral thesis in English; (3 used English extensively in writing their assignments, and in daily activities. Pseudonyms were used to refer to the participants as Sukarno and Suharto. The data were collected through in-depth interviews with the participants. The interview sessions took approximately 15-20 minutes for each participant and were videotaped and audiotaped. Semi-structured interview with 15 questions and probes were used. The results showed that the two participants had positive feelings and attitudes towards writing in English. Although they had a hard time in English writing during their undergraduate in Indonesia, they become fond of writing in English in their postgraduate time due to the exposure to English extensively. In composing, they used brainstorming, drafting, pausing, revising and editing in a recursive manner. Keywords: in-depth interview, pilot study, writing process, English as a Foreign Language (EFL

  20. Pharmacovigilance in veterinary medicine in Chile: a pilot study.

    Science.gov (United States)

    Iragüen, D; Urcelay, S; San Martín, B

    2011-04-01

    Iragüen, D., Urcelay, S., San Martín, B. Pharmacovigilance in veterinary medicine in Chile: a pilot study. J. vet. Pharmacol. Therap.34, 108-115. In Chile, there is no present government policy to survey and analyse adverse drug reactions (ADRs) in the field of veterinary medicine. The intent of this study is to assess, for the first time, ADR frequency in treated animals. To this purpose, a 6-month period pilot study based on WHO recommendations was conducted to monitor ADRs in cats and dogs for frequently used drugs and common labelled signs. Of a total of 149 detected ADRs, 29 (6 in cats and 23 in dogs) were notified by means of ADR report forms, while the rest was identified after reviewing patient clinical records, thus evidencing strong under-reporting problems. More than 70% of ADRs were related to antimicrobials, vaccines and tranquilizers. In dogs, there was a significant effect on ADRs' presentation when acepromazine, amoxicillin, carprofen, ivermectin, sextuple vaccine (polyvalent vaccine that confers immunity against canine distemper virus, canine parvovirus, Leptospira canicola, L. icterohemmoragiae, canine adenovirus type 2 and canine parainfluenza virus) and phytomenadione (subcutaneous injection) were administered. In the case of cats, a significant influence on ADRs was detected when acepromazine, amoxicillin or vitamin K was administered. Present results suggest the need for a pharmacovigilance programme in veterinary medicine for timely ADR-presenting drug detection and drug safety improvement.

  1. Development of a Burn Escharotomy Assessment Tool: A Pilot Study.

    Science.gov (United States)

    Ur, Rebecca; Holmes, James H; Johnson, James E; Molnar, Joseph A; Carter, Jeffrey E

    2016-01-01

    Severe burn injuries can require escharotomies which are urgent, infrequent, and relatively high-risk procedures necessary to preserve limb perfusion and sometimes ventilation. The American Burn Association Advanced Burn Life Support© course educates surgeons and emergency providers about escharotomy incisions but lacks a biomimetic trainer to demonstrate, practice, or provide assessment. The goal was to build an affordable biomimetic trainer with discrete points of failure and pilot a validation study. Fellowship-trained burn and plastic surgeons worked with special effect artists and anatomists to develop a biomimetic trainer with three discrete points of failure: median or ulnar nerve injury, fasciotomy, and failure to check distal pulse. Participants were divided between experienced and inexperienced, survey pre- and post-procedure on a biomimetic model while being timed. The trainer total cost per participant was less than $35. Eighteen participants were involved in the study. The inexperienced (0-1 prior escharotomies performed) had significantly more violations at the discrete points of failure relative to more experienced participants (P = .036). Face validity was assessed with 100% of participants agreement that the model appeared similar to real life and was valuable in their training. Given the advancements in biomimetic models and the need to train surgeons in how to perform infrequent, emergent surgical procedures, an escharotomy trainer is needed today. The authors developed an affordable model with a successful pilot study demonstrating discrimination between experienced and inexperienced surgeons. Additional research is needed to increase the reliability and assessment metrics.

  2. Pilot Study of the Pharmacokinetics of Cefotaxime in Critically Ill Patients with Acute Kidney Injury Treated with Continuous Renal Replacement Therapy

    NARCIS (Netherlands)

    Koedijk, Joost B.; Valk-Swinkels, Corinne G. H.; Rijpstra, Tom A.; Touw, Daan J.; Mulder, Paul G. H.; Van Der Voort, Peter H. J.; Van 't Veer, Nils E.; Van Der Meer, Nardo J. M.

    2016-01-01

    The objective of this study was to describe the pharmacokinetics of cefotaxime (CTX) in critically ill patients with acute kidney injury (AKI) when treated with continuous renal replacement therapy (CRRT) in the intensive care unit (ICU). This single-center prospective observational pilot study was

  3. Maquila Workers’ Health: Basic Issues, What is Known, and a Pilot Study in Nicaragua

    Directory of Open Access Journals (Sweden)

    Luis Blanco R.

    2008-09-01

    Full Text Available Occupational health issues identified in maquilas include respiratory, musculoskeletal, psychological problems, and accidents. This study identifies the basic health issues, as well as the sources and investigational methods needed for drafting health standards for maquilas. It sets out conceptual guidelines, suggesting general methodological strategies appropriate for studies of workers’ health and its determinants in the maquiladora sector. The conceptual-methodological model is based on 1 a review of relevant studies, 2 a mixed methods pilot feasibility study within the community of workers and social actors of a textile maquila in Nicaragua, and 3 the conceptual-methodological integration of a literature review with the results of the pilot study. The main issues identified are the organization of work, health, governmental regulation, family and gender, infrastructure and environment. Methodological recommendations focus on the principle of triangulation; the use of anonymous questionnaires and focus groups to examine specific issues; individual interviews with management personnel and members of the community; and the value of family members as key informers on the impact on family, environment and community. Observation of actual work procedures is ideal but not always possible. A joint health and safety committee and a health services unit would be key instruments in the prevention of accidents and illness and in health promotion and care.

  4. Parental Grief and Marital Issues Aftermath: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Nur Atikah Mohamed Hussin

    2016-06-01

    Full Text Available The death of a child is difficult to the bereaved parents. Literature had associated the loss with marriage disruption. The issues on that the difficulties to communicate, gender-related coping mechanisms and sexual need were discussed as reasons for bereaved parents to have conflict in their relationship. However there is limited knowledge about this issue. A pilot study has been conducted among six bereaved parents. The bereaved parents were Malaysian Muslim bereaved parents. They were interviewed individually to explore the challenges or conflicts that they had experienced after the death of their child. This study revealed that there were situations which bereaved parents described as having difficulties in their relationship. However, this study also revealed that the mutual understanding and respect to each other are the most of important components for bereaved parents to maintain their relationship post-loss. This study suggested the importance of suggesting couple counselling to bereaved parents after the death of their child.

  5. Cervical Spine Motion During Extrication: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Shafer, Jeffrey S

    2009-05-01

    Full Text Available Spinal immobilization is one of the most commonly performed pre-hospital procedures. Little research has been done on the movement of the neck during immobilization and extrication. In this study we used a sophisticated infrared six-camera motion-capture system (Motion Analysis Corporation, Santa Rosa, CA, to study the motion of the neck and head during extrication. A mock automobile was constructed to scale, and volunteer patients, with infrared markers on bony prominences, were extricated by experienced paramedics. We found in this pilot study that allowing an individual to exit the car under his own volition with cervical collar in place may result in the least amount of motion of the cervical spine. Further research should be conducted to verify these findings. In addition, this system could be utilized to study a variety of methods of extrication from automobile accidents. [WestJEM. 2009;10:74-78.

  6. Self-help group and the quality of life of patients with multiple sclerosis - Pilot study

    Directory of Open Access Journals (Sweden)

    Anna Eliášová

    2015-12-01

    Full Text Available Aim: The goal of the pilot study was to compare the quality of life of patients with multiple sclerosis in the Presov region with or without the support of a self-help group. Design: The character of this pilot study on patients with MS was related to the use of self-help groups and their impact on the assessment of the quality of life of the respondents, with the help of a questionnaire (WHOQOL-BREF. Methods: The research was carried out in the Prešov region with the help of the standardized WHOQOL-BREF questionnaire. Ninety-one patients with MS participated in the pilot study (46 respondents attended a self-help group and 35 did not. Results: The groups, when compared, aided by the statistically evaluated WHOQOL-BREF domains, were found to show significant differences in their evaluation of quality of life in three domains: domain one: physical health; domain two: surviving; domain three: social relations. Better scores were achieved in these domains by those who attended a group. In the physical sphere, we noticed significant differences in sleep quality, and sexual satisfaction (p < 0.001, while in social and economic areas, there were significant differences in satisfaction with personal relationships (p < 0.001, and economic circumstances (p < 0.01, self-contentment (p < 0.01, and coping with negative feelings (p < 0.05. Conclusion: Patients with multiple sclerosis can live normal lives provided they are supported by their families, friends, health care professionals, and self-help groups.

  7. Acupressure for smoking cessation – a pilot study

    Directory of Open Access Journals (Sweden)

    Moody Russell C

    2007-03-01

    Full Text Available Abstract Background Tobacco smoking is a serious risk to health: several therapies are available to assist those who wish to stop. Smokers who approach publicly funded stop-smoking clinics in the UK are currently offered nicotine replacement therapy (NRT or bupropion, and group behaviour therapy, for which there is evidence of effectiveness. Acupuncture and acupressure are also used to help smokers, though a systematic review of the evidence of their effectiveness was inconclusive. The aim of this pilot project was to determine the feasibility of a study to test acupressure as an adjunct to one anti-smoking treatment currently offered, and to inform the design of the study. Methods An open randomised controlled pilot study was conducted within the six week group programme offered by the Smoking Advice Service in Plymouth, UK. All participants received the usual treatment with NRT and group behavioural therapy, and were randomised into three groups: group A with two auricular acupressure beads, group B with one bead, and group C with no additional therapy. Participants were taught to press the beads when they experienced cravings. Beads were worn in one ear for four weeks, being replaced as necessary. The main outcome measures assessed in the pilot were success at quitting (expired CO ≤ 9 ppm, the dose of NRT used, and the rating of withdrawal symptoms using the Mood and Symptoms Scale. Results From 49 smokers attending four clinics, 24 volunteered to participate, 19 attended at least once after quitting, and seven remained to the final week. Participants who dropped out reported significantly fewer previous quit attempts, but no other significant differences. Participants reported stimulating the beads as expected during the initial days after quitting, but most soon reduced the frequency of stimulation. The discomfort caused by the beads was minor, and there were no significant side effects. There were technical problems with adhesiveness of

  8. [Protein-calorie nutritional state in elderly patients hospitalized in Lomé Campus university hospital: pilot study about 33 patients versus 30 reference cases registered in three care units].

    Science.gov (United States)

    Kouassi, K C; Lamboni, C

    2013-01-01

    Objective. The aim of this study was to determine the protein-calorie nutritional status of elderly hospitalized patients admitted to the hepato-gastroenterology, cardiology and internal medicine departments of the Lomé Campus University Hospital and identify the endogenous and mixed undernutrition to provide patients with better nutrition and assistance. Methodology. This cross-sectional study conducted between April 1 and July 31, 2009, included 33 hospitalized case patients aged at least 55 years and 30 age-matched outpatient control subjects. Patients were evaluated according to body mass index (BMI), the Mini Nutritional Assessment (MNA), and their serum albumin, serum prealbumin and orosomucoid levels. Results. Among the hospitalized case patients, 37% had protein-calorie undernutrition (low serum albumin), and 73% were at risk of this undernutrition (low serum prealbumin). Five patients (16%) were endogenously undernourished and 17 (57%) exogenously undernourished. Six to 13% of the oupatient controls were undernourished and 33% at risk of undernutrition according to the MNA scale. A significant difference existed between the mean albumin values of case patients and controls (38 ± 9 g/L vs 46 ± 7 g/L, p = 0.002). Conclusion. Our results confirm that the elderly inpatients were regularly malnourished. Knowledge of their nutritional profile has allowed us to launch an improved nutritional assistance program and to supervise it properly.

  9. 77 FR 13343 - Pilot Program for Early Feasibility Study Investigational Device Exemption Applications...

    Science.gov (United States)

    2012-03-06

    ... HUMAN SERVICES Food and Drug Administration Pilot Program for Early Feasibility Study Investigational... for early feasibility study IDE applications. FDA is also announcing that the duration of the pilot... ``Investigational Device Exemptions (IDE) for Early Feasibility Medical Device Clinical Studies, Including...

  10. CHASE assessment of the North Sea – a pilot study

    DEFF Research Database (Denmark)

    Green, N.; Andersen, Jesper; Høgåsen, T.;

    In this pilot study, hazardous substances in the North Sea were assessed and classified using the HELCOM Chemical Substances Status Assessment Tool (CHASE). The study was based on monitoring by Belgium, Denmark, France, Germany, the Netherlands, Norway, Sweden and the United Kingdom. Together, 1350...... assessment and classification of “hazardous substances status”. This can be in particular advantageous for use in remedial action plan and, in particular, for the sciencebased evaluation of whether the North Sea is undisturbed by hazardous substances....... locations (1155 for sediment and 195 for biota) were used resulting in 966 matrices sampled in the open-sea and 506 in coastal areas. CHASE is a multi-metric indicator-based tool developed for the HELCOM integrated thematic assessment of hazardous substances in the Baltic Sea. CHASE produces an integrated...

  11. Canine heartworm disease: a review and pilot study.

    Science.gov (United States)

    Haddock, K C

    1987-01-01

    Canine heartworm disease is a mosquito vectored illness resulting from parasitization by the filariid worm Dirofilaria immitis. While presenting some danger to humans, the filariid has its greatest impact on the canine population. In recent years the disease has become established throughout much of the United States, perhaps as the result of diffusion from a suspected hearth in the southeastern coastal plain. While its distribution is known in general terms, much research remains to be done to assess the pattern of distribution as well as the impact of D. immitis on canine populations and their human owners for many locales. The present study provides a review of the literature on the parasite; on its distribution, particularly in the United States; and on the ecology of canine heartworm disease. A pilot study is presented which emphasizes the problems encountered in establishing a data base for observations on the disease at the local level.

  12. Improving empathy and relational skills in otolaryngology residents: a pilot study.

    Science.gov (United States)

    Riess, Helen; Kelley, John M; Bailey, Robert; Konowitz, Paul M; Gray, Stacey Tutt

    2011-01-01

    Physician empathy and relational skills are critical factors predicting quality of care, patient safety, patient satisfaction, and decreasing malpractice claims. Studies indicate that physician empathy declines throughout medical training, yet little is published about methods to enhance empathy, especially in surgical residency training. The Accreditation Council for Graduate Medical Education requires competencies in 6 areas, including interpersonal skills and communication. To address this important problem, the first author developed an innovative empathy-relational skills training protocol focusing on the underlying neurobiological mechanisms of empathy and the interpersonal processes that positively affect the patient-doctor relationship. The authors tested the effectiveness of this protocol in a pilot study with 11 otolaryngology residents. Results showed that a brief series of 3 empathy training sessions can significantly improve physicians' knowledge of the neurobiology and physiology of empathy, as well as their self-reported capacity to empathize with patients. A trend toward increased patient satisfaction was observed.

  13. Plasma soluble prion protein, a potential biomarker for sport-related concussions: a pilot study.

    Science.gov (United States)

    Pham, Nam; Akonasu, Hungbo; Shishkin, Rhonda; Taghibiglou, Changiz

    2015-01-01

    Sport-related mild traumatic brain injury (mTBI) or concussion is a significant health concern to athletes with potential long-term consequences. The diagnosis of sport concussion and return to sport decision making is one of the greatest challenges facing health care clinicians working in sports. Blood biomarkers have recently demonstrated their potential in assisting the detection of brain injury particularly, in those cases with no obvious physical injury. We have recently discovered plasma soluble cellular prion protein (PrP(C)) as a potential reliable biomarker for blast induced TBI (bTBI) in a rodent animal model. In order to explore the application of this novel TBI biomarker to sport-related concussion, we conducted a pilot study at the University of Saskatchewan (U of S) by recruiting athlete and non-athlete 18 to 30 year-old students. Using a modified quantitative ELISA method, we first established normal values for the plasma soluble PrP(C) in male and female students. The measured plasma soluble PrP(C) in confirmed concussion cases demonstrated a significant elevation of this analyte in post-concussion samples. Data collected from our pilot study indicates that the plasma soluble PrP(C) is a potential biomarker for sport-related concussion, which may be further developed into a clinical diagnostic tool to assist clinicians in the assessment of sport concussion and return-to-play decision making.

  14. Plasma soluble prion protein, a potential biomarker for sport-related concussions: a pilot study.

    Directory of Open Access Journals (Sweden)

    Nam Pham

    Full Text Available Sport-related mild traumatic brain injury (mTBI or concussion is a significant health concern to athletes with potential long-term consequences. The diagnosis of sport concussion and return to sport decision making is one of the greatest challenges facing health care clinicians working in sports. Blood biomarkers have recently demonstrated their potential in assisting the detection of brain injury particularly, in those cases with no obvious physical injury. We have recently discovered plasma soluble cellular prion protein (PrP(C as a potential reliable biomarker for blast induced TBI (bTBI in a rodent animal model. In order to explore the application of this novel TBI biomarker to sport-related concussion, we conducted a pilot study at the University of Saskatchewan (U of S by recruiting athlete and non-athlete 18 to 30 year-old students. Using a modified quantitative ELISA method, we first established normal values for the plasma soluble PrP(C in male and female students. The measured plasma soluble PrP(C in confirmed concussion cases demonstrated a significant elevation of this analyte in post-concussion samples. Data collected from our pilot study indicates that the plasma soluble PrP(C is a potential biomarker for sport-related concussion, which may be further developed into a clinical diagnostic tool to assist clinicians in the assessment of sport concussion and return-to-play decision making.

  15. Fighter Pilot Ejection Study as an Educational Tool

    Science.gov (United States)

    Robinson, Garry; Jovanoski, Zlatko

    2010-01-01

    In this article, we apply the well-known equations of projectile motion to the case of a fighter pilot ejecting from an aircraft, the aim being to establish under what conditions there is danger of impact with the rear vertical stabilizer. The drag force on the pilot after ejection is assumed to vary as the velocity squared and the aircraft motion…

  16. Impact of nutrition messages on children's food choice: pilot study.

    Science.gov (United States)

    Bannon, Katie; Schwartz, Marlene B

    2006-03-01

    This pilot study tested the influence of nutrition message framing on snack choice among kindergarteners. Three classrooms were randomly assigned to watch one of the following 60s videos: (a) a gain-framed nutrition message (i.e. the positive benefits of eating apples) (n=14); (b) a loss-framed message (i.e. the negative consequences of not eating apples) (n=18); or (c) a control scene (children playing a game) (n=18). Following this, the children were offered a choice between animal crackers and an apple for their snack. Among the children who saw one of the nutrition message videos, 56% chose apples rather than animal crackers; in the control condition only 33% chose apples. This difference was statistically significant (chi2=7.56, p<0.01). These results suggest that videos containing nutritional messages may have a positive influence on children's short-term food choices.

  17. A novel assessment of adolescent mobility: a pilot study

    DEFF Research Database (Denmark)

    Stewart, Tom; Duncan, Scott; Chaix, Basile

    2015-01-01

    . The recent development of VERITAS - a web-based application nested within a computer-assisted personal interview - allows researchers to assess daily mobility, travel to regular destinations, and perceived neighbourhood boundaries using interactive mapping technology. The aims of this pilot study were to (1......BACKGROUND:The accurate measurement of daily mobility and travel to destinations beyond the residential neighbourhood has been identified as an important but almost systematically overlooked factor when investigating the relationship between exposure to the built environment and physical activity......) demonstrate the feasibility and functionality of using VERITAS in an adolescent sample, and (2) compare urban form characteristics and geometric features of the perceived neighbourhood with traditional neighbourhood delimitations.METHODS:Data were collected and analysed for twenty-eight participants (14 male...

  18. Entrepreneurial behavior among employees. Pilot study: Employees from Bucharest

    Directory of Open Access Journals (Sweden)

    Ionuţ Constantin

    2015-12-01

    Full Text Available Many objective or subjective factors influence the decision to open a business. The most important factors are: the existence of an adequate opportunity or a market, perception that starting a business could be difficult because of bureaucracy, financial barriers or the need to acquire new skills, a lack of money, etc. Also, entrepreneurial behavior is generally influenced by socio-economic status of the family of origin [1]. Thus, children from wealthy families have the “competitive advantage” to receive an education appropriate for managing a business and of course have the necessary financial resources and its start [2]. However, abilities of every individual can “correct’’ these benefits are completely eliminated/reduced exogenous barriers [3]. In this article I will present the results of a pilot study conducted in 2014 at Bucharest employees to observe their entrepreneurial behavior.

  19. Early caries detection: comparison of two procedures. A pilot study

    Directory of Open Access Journals (Sweden)

    Fabrizio Guerra

    2016-12-01

    Full Text Available Caries is one of the most common chronic diseases and the main cause of tooth loss. Early detection provides a better evaluation of the disease and improves the chances to succeed of prevention strategies. This pilot study aims to compare the effectiveness of ICDAS-II system (International Caries Detection and Assessment System and the fluorescence terminal (Proof of VistaCam iX intraoral camera, in the early diagnosis and assessment of caries in permanent teeth. Results shows a fair correlation between ICDAS II and VistaCam iX Proof; intraoral camera proved to be a useful support to the ICDAS II visual / tactile monitoring of carious lesions in occlusal surfaces.

  20. Pilot study of manual sugarcane harvesting using biomechanical analysis.

    Science.gov (United States)

    Clementson, C L; Hansen, A C

    2008-07-01

    In many countries, sugar cane harvesting is a very labor-intensive activity in which workers usually become fatigued after manually cutting the cane for a few hours. They need frequent pauses for rest, and they experience sustained injuries from excessive stress on the joints and muscles of the body. The cutting tool and motion involved directly influence the stresses created. A cutting tool that has not been designed by taking into consideration occupational biomechanics can lead to unnecessary strains in the body's muscle system, resulting in injuries. The purpose of this research was to carry out a pilot study of the impact of two common manual sugarcane cutting tools and the cutting posture they induce on the body with the aid of biomechanics. The machete and the cutlass from South Africa and Guyana, respectively, were examined to determine the cutting forces. Using static strength prediction modeling, the body stress levels at the point of cut in the cutting motion were determined. The cutting postures of three subjects were contrasted, their extreme postures were identified, and suggestions were made to improve the ergonomics of the cutting activity. The results of this pilot study showed that the cutlass required less cutting force than the machete because of the slicing cut provided by the curved blade edge of the cutlass. However, the biomechanical analysis indicated that the bent blade of the machete required less flexion of the back and therefore was likely to cause less back fatigue and injury. An improved design of the sugarcane manual harvesting tool should incorporate the bend of the machete to reduce flexion and a curved cutting edge that provides a slicing cut.

  1. A Pilot Study on Measuring Customer’s Satisfaction Level

    Directory of Open Access Journals (Sweden)

    Vide Boltez

    2013-01-01

    Full Text Available RQ: Determine the level of customer satisfaction of a company’s products and services to obtain information on needed improvements.Purpose: The purpose of measuring customer’s satisfaction level is to obtain information directly from the final buyer that bought our product. The next step is to analyze the information obtained and to take the results into consideration to improve the working process in production and in other departments of the company.Method: The method used for the pilot study to measure customer satisfaction was a short questionnaire that was given to 10 customers of our product and 10 completed questionnaires were obtained.Results: The results showed the level of satisfaction of final buyers of roof tiles and roofs that the company has achieved through their products and services. The results facilitate the production, logistics, purchasing and sales department to obtain information on positive satisfaction levels and areas that need change. At the same time, the final buyer was identified (i.e., name, surname, address, and so forth, which up until now had not been.Organization: The organization will save time and money in the future, because it will continuously measure customer satisfaction to improve production and other departments in the organization towards creating satisfied customers.Society: Final buyers of roofs are, and will be, more satisfied with their decisions, because the organization carries out after-sales satisfaction levels.Originality: The research was original, because up to this date the organization has not conducted research in such a manner.Limitations: The pilot study used 10 completed questionnaires that represent a very small sample to make any generalizations.

  2. Tryptophan degradation in women with breast cancer: a pilot study

    Directory of Open Access Journals (Sweden)

    Schubert Christine M

    2011-05-01

    Full Text Available Abstract Background Altered tryptophan metabolism and indoleamine 2,3-dioxygenase activity are linked to cancer development and progression. In addition, these biological factors have been associated with the development and severity of neuropsychiatric syndromes, including major depressive disorder. However, this biological mechanism associated with both poor disease outcomes and adverse neuropsychiatric symptoms has received little attention in women with breast cancer. Therefore, a pilot study was undertaken to compare levels of tryptophan and other proteins involved in tryptophan degradation in women with breast cancer to women without cancer, and secondarily, to examine levels in women with breast caner over the course of chemotherapy. Findings Blood samples were collected from women with a recent diagnosis of breast cancer (n = 33 before their first cycle of chemotherapy and after their last cycle of chemotherapy. The comparison group (n = 24 provided a blood sample prior to breast biopsy. Plasma concentrations of tryptophan, kynurenine, and tyrosine were determined. The kynurenine to tryptophan ratio (KYN/TRP was used to estimate indoleamine 2,3-dioxygenase activity. On average, the women with breast cancer had lower levels of tryptophan, elevated levels of kynurenine and tyrosine and an increased KYN/TRP ratio compared to women without breast cancer. There was a statistically significant difference between the two groups in the KYN/TRP ratio (p = 0.036, which remained elevated in women with breast cancer throughout the treatment trajectory. Conclusions The findings of this pilot study suggest that increased tryptophan degradation may occur in women with early-stage breast cancer. Given the multifactorial consequences of increased tryptophan degradation in cancer outcomes and neuropsychiatric symptom manifestation, this biological mechanism deserves broader attention in women with breast cancer.

  3. Spontaneous monitoring of adverse reactions to drugs by Italian dermatologists: a pilot study. Gruppo Italiano Studi Epidemiologici in Dermatologia.

    Science.gov (United States)

    1991-01-01

    During 1988, the Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED) coordinated a pilot study aimed at evaluating the feasibility of a system for spontaneous monitoring of adverse drug reactions in dermatological practice in Italy. Approximately 400 dermatologists were asked to collaborate, and 141 agreed to the study. Procedures similar to those well established in other surveillance programs (including the use of standard forms and standardized assessment procedure) were adopted. In a 2-month period 775 reports were collected, of which 711 were maintained after careful evaluation. The general profile of the adverse reactions reported was in accordance with the experience derived by other spontaneous surveillance programs. The main purpose of spontaneous reporting systems is the identification of new reactions, and a model analysis was proposed, in our study, with reference to skin reactions to bamifylline. The demonstration of the feasibility of a drug-monitoring program in Italy, where little tradition exists in the area, is the most important result of our study.

  4. Pilot Implementations

    DEFF Research Database (Denmark)

    Manikas, Maria Ie

    tensions and negotiations are fundamental characteristics of pilot implementations. Based on the analysis of a project that is pilot implementing an electronic pre-hospital patient record for emergency medical services in Danish health care, I investigate other perceptions of pilot implementations....... The analysis is conducted by means of a theoretical framework that centres on the concept infrastructure. With infrastructure I understand the relation between organised practice and the information systems supporting this practice. Thus, infrastructure is not a thing but a relational and situated concept...... understanding of pilot implementations as enacted interventions into existing infrastructures. Moreover, being embedded in the day-to-day organisation of work pilot implementations intervenes in the conventions of practice making the taken for granted visible. This allows project participants to attend...

  5. Managerial span of control: a pilot study comparing departmental complexity and number of direct reports.

    Science.gov (United States)

    Merrill, Katreena Collette; Pepper, Ginette; Blegen, Mary

    2013-09-01

    Nurse managers play pivotal roles in hospitals. However, restructuring has resulted in nurse managers having wider span of control and reduced visibility. The purpose of this pilot study was to compare two methods of measuring span of control: departmental complexity and number of direct reports. Forty-one nurse managers across nine hospitals completed The Ottawa Hospital Clinical Manager Span of Control Tool (TOH-SOC) and a demographic survey. A moderate positive relationship between number of direct reports and departmental complexity score was identified (r=.49, p=<.01). Intensive care departments were more likely to be classified differently, using departmental complexity compared to number of direct reports (54%). TOH-SOC is a reliable instrument (Cronbach's alpha = .838). Using departmental complexity rather than direct reports may more accurately reflect the full scope of nurse managers' responsibility.

  6. Reiki for Cancer Patients Undergoing Chemotherapy in a Brazilian Hospital: A Pilot Study.

    Science.gov (United States)

    Siegel, Pamela; da Motta, Pedro Mourão Roxo; da Silva, Luis G; Stephan, Celso; Lima, Carmen Silvia Passos; de Barros, Nelson Filice

    2016-01-01

    The purpose of this pilot study was to explore whether individualized Reiki given to cancer patients at a Brazilian hospital improved symptoms and well-being. Data from 36 patients who received 5 Reiki sessions were collected using the MYMOP and were compared before and after their treatment and also with 14 patients who did not receive Reiki and who acted as a comparison group. Twenty-one patients reported feeling better, 12 felt worse, and 3 reported no change. Of the comparison group, 6 patients reported feeling better and 8 felt worse. The Reiki practice delivered as part of the integrative care in oncology did produce clinically significant effects, although not statistically significant results, for more than half of the patients undergoing cancer treatment.

  7. Collagen content as a risk factor in breast cancer? A pilot clinical study

    Science.gov (United States)

    Pifferi, Antonio; Quarto, Giovanna; Abbate, Francesca; Balestreri, Nicola; Menna, Simona; Cassano, Enrico; Cubeddu, Rinaldo; Taroni, Paola

    2015-07-01

    A retrospective pilot clinical study on time domain multi-wavelength (635 to 1060 nm) optical mammography was exploited to assess collagen as a breast-cancer risk factor on a total of 109 subjects (53 healthy and 56 with malignant lesions). An increased cancer occurrence is observed on the 15% subset of patients with higher age-matched collagen content. Further, a similar clustering based on the percentage breast density leads to a different set of patients, possibly indicating collagen as a new independent breast cancer risk factor. If confirmed statistically and on larger numbers, these results could have huge impact on personalized diagnostics, health care systems, as well as on basic research.

  8. Dental Students’ Knowledge of Oral Health for Persons with Special Needs: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Fouad Salama

    2015-01-01

    Full Text Available Objectives. The purpose of this pilot study was to assess the knowledge and awareness of dental students with respect to oral health care of the person with special health care needs (SHCN and evaluate effectiveness of an education program on improving their knowledge. Method. An evaluation consisting of a questionnaire was answered before and immediately after a 30-minute educational presentation in the form of a DVD that includes a PowerPoint and a video of oral health care for individuals with SHCN. The questionnaire was based on the materials and information presented in the DVD and included 26 questions (true/false/I do not know. Results. The mean (±SD score on the pretest was 10.85 (±5.20, which increased to 16.85 (±5.47 on the posttest. This difference was statistically significant (P<0.001. Forty percent of the students surveyed reported that they were very satisfied with the educational part of the presentation, while 50% were somewhat satisfied. Thirty percent of students expressed that the educational intervention used is very effective. Conclusions. Viewing the educational intervention was effective in informing the sophomore students and providing them with instructive basic information on person with SHCN. Dental colleges should increase students’ knowledge, training, and exposure to individuals with SHCN.

  9. Lessons learned from implementing a pilot RCT of transitional care model for individuals with serious mental illness.

    Science.gov (United States)

    Solomon, Phyllis; Hanrahan, Nancy P; Hurford, Matthew; DeCesaris, Marissa; Josey, LaKeetra

    2014-08-01

    We adapted an evidence-based transitional care model for older adults being released from acute care hospitals for patients with serious mental illness and medical co-morbidities being discharged from two psychiatric units of an acute care hospital (TCare) and evaluated implementation issues. An advisory group (AG) of community stakeholders assessed barriers and facilitators of a 90-day T-Care intervention delivered by a psychiatric nurse practitioner (NP) in the context of conducting a pilot randomized controlled trial. Minutes of AG and case narratives by NP of 20 intervention participants were content analyzed. Patients with immediate and pressing physical health problems were most receptive and actively utilized the service. Provider barriers consisted of communication and privacy issues making it difficult to contact patients in mental health facilities. In contrast, the NP was accepted and valued in the physical health arena. Psychosocial needs and relationship issues were demanding, and we recommend a team approach for TCare with the addition of a social worker, peer provider, and consulting psychiatrist for severely mentally ill patients being released from an acute physical health hospitalization.

  10. 77 FR 12312 - Electronic Submission of Nonclinical Study Data; Notice of Pilot Project

    Science.gov (United States)

    2012-02-29

    ... study data. SEND was developed by the CDISC SEND Team. CDISC is an open, multidisciplinary, nonprofit... regulatory review, the CDISC SEND team, in collaboration with FDA and available pilot participants, will... be used to support review activity. Participation in the pilot program is open to all sponsors....

  11. Transient ischaemic attack and stroke risk: pilot of a primary care electronic decision support tool

    Directory of Open Access Journals (Sweden)

    Ranta A

    2013-06-01

    Full Text Available INTRODUCTION: Transient ischaemic attacks (TIAs indicate high risk for stroke and rapid management reduces stroke burden. Rapid specialist access to initiate timely management is often challenging to achieve. AIM: To assess the feasibility of implementing a TIA/Stroke electronic decision support (EDS tool intended to aid general practitioners (GPs in the timely management of TIAs. METHODS: An eight-week pilot provided access to the TIA/Stroke EDS to selected GPs in the MidCentral district, with subsequent patient record review and a post-pilot user satisfaction survey. RESULTS: Eleven patients from eight practices were entered into the tool and when EDS-rendered advice was followed, diagnosis was accurate and management was in accordance with New Zealand TIA guidelines. No adverse outcomes resulted and user feedback was positive. DISCUSSION: Results indicate that wider implementation of the TIA/Stroke EDS tool is feasible.

  12. Working on asymmetry in Parkinson's disease: randomized, controlled pilot study.

    Science.gov (United States)

    Ricciardi, Lucia; Ricciardi, Diego; Lena, Francesco; Plotnik, Meir; Petracca, Martina; Barricella, Simona; Bentivoglio, Anna Rita; Modugno, Nicola; Bernabei, Roberto; Fasano, Alfonso

    2015-08-01

    Posture, gait and balance problems are very disabling symptoms in Parkinson's disease (PD). An increased stride-to-stri de variability, reduction of automaticity and asymmetry of lower limbs function characterize parkinsonian gait. These features predispose to freezing of gait (FOG), which often leads to falls. The aim of this study was to evaluate how the modulation of asymmetry through physiotherapy might improve gait and reduce FOG, thus preventing falls. Twenty-eight PD patients entered a double-blind pilot feasibility controlled study and were evaluated at baseline and after 3 months of a rehabilitative program (performed twice a week) by means of the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS-III), Gait and Falls Questionnaire, Tinetti balance and gait scale, Short Physical Performance Battery (SPPB), European Quality of Life questionnaire. Patients were randomly assigned to three treatment arms: (1) worst side improvement; (2) best side improvement; (3) standard therapy. All study arms showed a significant improvement of the Tinetti and SPPB scores. BSI led to a greater improvement than ST in terms of UPDRS-III (p = 0.01); Tinetti total score (p = 0.05) and Tinetti gait subscore (p = 0.01). Our study confirms the efficacy of physical therapy in the treatment of PD and, more importantly, suggests that specific intervention tailored on individual feature (e.g., asymmetry of motor condition) might be even more effective than standard rehabilitative programs.

  13. The Hong Kong vision study: a pilot assessment of visual impairment in adults.

    OpenAIRE

    Van Newkirk, M R

    1997-01-01

    PURPOSE: The Hong Kong Adult Vision Pilot Study is a population based study of the distribution and determinants of eye disease in a random sample of the Chinese population age 40 and over. The present pilot study identifies the extent and causes of visual loss using methods developed in the United States and Australia. The pilot study uses the prevalence data to estimate the sample size necessary to predict the size of an effect a larger study may detect and the confidence with which that ef...

  14. Plant substrate as a vehicle for trituration: a pilot study

    Directory of Open Access Journals (Sweden)

    Rodrigo Mariani Verginelli

    2012-09-01

    Full Text Available Motivation: Lactose and hydroalcoholic solutions are not the proper substances to study the High Dilution (HD effects using plant models. Plant substrate can not be considered an inert vehicle, but it is not harmful to plants. Aim: In this pilot study we verify the possibility to use plant substrate as a trituration vehicle to prepare substances to be used in plants. Methods: We used a partially dried commercial plant substrate (12% humidity as the vehicle to prepare a set of trituration, having NaCl as the initial active substance. Triturations were performed using a ball mill, with a mass dilution rate of 1:18 (set A and 1:100 (set B, up to the 7th trituration, that is, each set contained 8 groups: A0 to A7 and B0 to B7. For each group, the triturated substrate was mixed with a fresh one in a mass ratio of 1:1. After homogenization, 18 seeds of radish (Raphanus sativus were sown in plastic trays (31 ml cell, for each group and kept in a green house exposed to natural thermal and light variations. After 4 weeks we determine the germination rate and number of mature cotyledon. Then 5 plants from each group were selected at random to determine the following parameters: averaged leaf area, length, fresh and dry mass and pigments amount (chlorophyll a and b, carotenes. Results: Groups A0 and B0 (higher saline concentration showed those typical effects of saline stress: lower germination ratio, immature cotyledons, smaller and shorter leaves, higher water content and less pigments. All the others groups showed similar results, for all parameters, except pigments amount. The chlorophyll to carotene ratio (CCr showed an unexpected but interesting behavior (figure 1.Both sets showed an initial CCr growing (as expected due the saline ratio decrease, but followed by an unexpected decrement. Set B (the higher mass dilution rate, 1:100 showed a slower change, compared to set A. When we sort the results in order of saline amount we observe two peaks (figure

  15. When doctors come to prison – a pilot project for better HIV care in correctional facilities

    Directory of Open Access Journals (Sweden)

    I Vaz Pinto

    2012-11-01

    Full Text Available Recent rearrangements in national policies regarding follow-up of HIV-infected inmates have determined that hospitals closest to the prison facility be responsible for their care. Our HIV Unit and the two prison facilities in the area have established a clinical protocol whereby a clinical team goes to the prisons for blood collecting and visits instead of having the inmates transported to the hospital. The purpose of the protocol, from a clinical point of view, was to: (i promote adherence to blood tests and clinical visits; (ii promote adherence to antiretroviral (ARV therapy; (iii facilitate ARV administration by promoting once-daily-dosing. This retrospective review looks back at the first year of protocol implementation between the HIV Unit of HPP Cascais Hospital and the prisons of Tires and Linhó. The purpose of this study is to characterize the demographics of our inmate population; assess the number of inmates on ARV and describe the regimens as PI- or NNRTI-based and as once- or twice-daily dosed; evaluate ARV efficacy by HIV viral load undetectability; and assess opportunity for ARV switch from twice- to once-daily dosing. From April 2011 until June 2012 a total of 53 inmates were included in this protocol. The majority of patients were female (55% as one of the prisons is mainly for female inmates. The median age is 36 years (from 23–59. The average time of follow-up was 11 months (15 months maximum. From the total of 53 patients under study, 40 are currently under care, the other 13 having been released or transferred to other prison facilities. The majority of these patients are on ARV therapy (83%. By the end of follow-up time 88% of patients were on a once-daily dosed regimen; these are PI-based in 69% and NNRTI-based in 31%. At their last evaluation, 32/33 patients on therapy had undetectable HIV viremia (97%. As a conclusion, we assess that this protocol implementation has benefitted all parts: patients assure regular

  16. Microcirculation and atherothrombotic parameters in prolactinoma patients: a pilot study.

    Science.gov (United States)

    Reuwer, Anne Q; Sondermeijer, Brigitte M; Battjes, Suzanne; van Zijderveld, Rogier; Stuijver, Danka J F; Bisschop, Peter H; Twickler, Marcel Th B; Meijers, Joost C M; Schlingemann, Reinier O; Stroes, Erik S

    2012-12-01

    Atherothrombosis is a multifactorial process, governed by an interaction between the vessel wall, hemodynamic factors and systemic atherothrombotic risk factors. Recent in vitro, human ex vivo and animal studies have implicated the hormone prolactin as an atherothrombotic mediator. To address this issue, we evaluated the anatomy and function of various microvascular beds as well as plasma atherothrombosis markers in patients with elevated prolactin levels. In this pilot study, involving 10 prolactinoma patients and 10 control subjects, sidestream dark field (SDF) imaging revealed a marked perturbation of the sublingual microcirculation in prolactinoma patients compared to control subjects, as attested to by significant changes in microvascular flow index (2.74 ± 0.12 vs. 2.91 ± 0.05, respectively; P = 0.0006), in heterogeneity index (0.28 [IQR 0.18-0.31] vs. 0.09 [IQR 0.08-0.17], respectively; P = 0.002) and lower proportion of perfused vessels (90 ± 4.0% vs. 95 ± 3.0%, respectively; P = 0.016). In the retina, fluorescein angiography (FAG) confirmed these data, since prolactinoma patients more often have dilatated perifoveal capillaries. In plasma, prolactinoma patients displayed several pro-atherogenic disturbances, including a higher endogenous thrombin potential and prothrombin levels as well as decreased HDL-cholesterol levels. Prolactinoma patients are characterized by microvascular dysfunction as well as plasma markers indicating a pro-atherothrombotic state. Further studies are required to assess if prolactin is causally involved in atherothrombotic disease.

  17. Do chiropractic college faculty understand informed consent: a pilot study

    Directory of Open Access Journals (Sweden)

    Hondras Maria A

    2006-12-01

    Full Text Available Abstract Background The purpose of this study was to survey full-time faculty at a single chiropractic college concerning their knowledge of Institutional Review Board (IRB policies in their institution as they pertain to educational research. Methods All full-time faculty were invited to participate in an anonymous survey. Four scenarios involving educational research were described and respondents were asked to select from three possible courses of action for each. In addition, respondents were queried about their knowledge of IRB policies, how they learned of these policies and about their years of service and departmental assignments. Results The response rate was 55%. In no scenario did the level of correct answers by all respondents score higher than 41% and in most, the scores were closer to just under 1 in 3. Sixty-five percent of respondents indicated they were unsure whether Palmer had any policies in place at all, while 4% felt that no such policies were in place. Just over one-quarter (27% were correct in noting that students can decline consent, while more than half (54% did not know whether there were any procedures governing student consent. Conclusion Palmer faculty have only modest understanding about institutional policies regarding the IRB and human subject research, especially pertaining to educational research. The institution needs to develop methods to provide knowledge and training to faculty. The results from this pilot study will be instrumental in developing better protocols for a study designed to survey the entire chiropractic academic community.

  18. A pilot study on mindfulness based stress reduction for smokers

    Directory of Open Access Journals (Sweden)

    Baker Timothy B

    2007-01-01

    Full Text Available Abstract Background Mindfulness means paying attention in the present moment, non-judgmentally, without commentary or decision-making. We report results of a pilot study designed to test the feasibility of using Mindfulness Based Stress Reduction (MBSR (with minor modifications as a smoking intervention. Methods MBSR instructors provided instructions in mindfulness in eight weekly group sessions. Subjects attempted smoking cessation during week seven without pharmacotherapy. Smoking abstinence was tested six weeks after the smoking quit day with carbon monoxide breath test and 7-day smoking calendars. Questionnaires were administered to evaluate changes in stress and affective distress. Results 18 subjects enrolled in the intervention with an average smoking history of 19.9 cigarettes per day for 26.4 years. At the 6-week post-quit visit, 10 of 18 subjects (56% achieved biologically confirmed 7-day point-prevalent smoking abstinence. Compliance with meditation was positively associated with smoking abstinence and decreases in stress and affective distress. Discussions and conclusion The results of this study suggest that mindfulness training may show promise for smoking cessation and warrants additional study in a larger comparative trial.

  19. Music Therapy With Premature Infants and Their Caregivers in Colombia – A Mixed Methods Pilot Study Including a Randomized Trial

    OpenAIRE

    Mark Ettenberger; Helen Odell-Miller; Cátherine Rojas Cárdenas; Sergio Torres Serrano; Mike Parker; Sandra Milena Camargo Llanos

    2014-01-01

    This article reports the results of a three-arm mixed methods pilot study of music therapy with premature infants and their caregivers in a Neonatal Intensive Care Unit (NICU) in Bogotá, Colombia. The study included 19 medically stable babies born between the 30th and 37th week of gestation and their caregivers. Two intervention groups were compared with a control group. The objectives were to find out whether music therapy could help the neonates to stabilize their physiological states a...

  20. The use of clinical logs to improve nursing students' metacognition: a pilot study.

    Science.gov (United States)

    Fonteyn, M E; Cahill, M

    1998-07-01

    The purpose of this study was to examine the effectiveness of the use of a reflective clinical log to improve students' thinking strategies and metacognition (cognitive awareness). Rather than prepare a written nursing care plan prior to entering the clinical setting, students instead were asked to write in a clinical log at the completion of their clinical day, reflecting upon client problems that they had identified, the data that were used to identify these problems, the nursing interventions that were used, and the results of these interventions. The students reported that they preferred the use of a reflective log over writing nursing care plans and they felt that the logs improved their ability to think about their thinking (i.e. their metacognition). The results of this pilot study indicate that reflection in clinical logs assists students to become more active learners, to manage their own thinking, and to improve their metacognition. Additional research in this area is needed to confirm study findings and to provide further understanding regarding the effectiveness of clinical logs as a teaching strategy to improve students' metacognition.

  1. Catalog of Completed Health Care and Dental Care Studies.

    Science.gov (United States)

    1987-12-01

    Specialist Corps Health Care Studies Division EDUCATION: B.S., 1967, Foods and Nutrition , Carnegie-Mellon University, Pittsburgh, PA M.H.A., 1979...Licensed Dietitian, Texas PJBLICATIONS: Begg, I. (1978). Marketing of nutrition . U.S. Army - Baylor University Bul letin of Continuing Graduate Education...Yuille, D., Telepak, R.J., Lamibrecht, R.W., & McAuley, R.J. (1978). Radionuclide nurshmal low swallow for evaluation of dysphagia . Journal of

  2. A pilot study of coronary angioplasty in outpatients.

    OpenAIRE

    Laarman, G.J.; Kiemeneij, F.; van der Wieken, L R; Tijssen, J.G.; Suwarganda, J S; Slagboom, T.

    1994-01-01

    BACKGROUND--Is it safe to discharge patients from hospital on the same day as percutaneous transluminal coronary angioplasty (PTCA)? The hypothesis tested was that careful pre and post angioplasty selection of patients can identify a group that is at very low risk of postprocedural complications and that these patients may be discharged on the day of the procedure. METHODS--63 patients undergoing limited risk coronary angioplasty of 72 lesions were studied. So that patients would be able to w...

  3. Impact of healing touch on pediatric oncology outpatients: pilot study.

    Science.gov (United States)

    Kemper, Kathi J; Fletcher, Nancy B; Hamilton, Craig A; McLean, Thomas W

    2009-01-01

    Healing Touch (HT) is a biofield therapy used to enhance well-being. We conducted a pilot study to assess its effects in pediatric oncology patients. We enrolled patients in the continuation or consolidation phase of therapy. Patients or their parent completed simple visual analogue scales (VASs; 0-10) for relaxation, vitality, overall well-being, stress, anxiety, and depression before and after a 20-minute period of rest and a standardized HT treatment. Patients' heart rates were monitored and later analyzed for heart rate variability (HRV) characteristics. Of the nine patients, all completed VASs and six had usable HRV data. The average age was 9 years. VAS scores for stress decreased significantly more for HT treatment than for rest (HT: 4.4-1.7; rest: 2.3-2.3; p = .03). The HRV characteristic of total power was significantly lower during HT than for rest (HT 599 +/- 221; rest: 857 +/- 155; p = .048), and sympathetic activity was somewhat but not significantly lower (HT: 312 +/- 158; rest: 555 +/- 193; p = .06). HT is associated with lowered stress and changes in HRV. Further studies are needed to understand the mechanisms of these effects in larger samples and to explore the impact on additional clinically relevant measures.

  4. PACAP38 dose-response pilot study in migraine patients

    DEFF Research Database (Denmark)

    Vollesen, Anne Luise Haulund; Guo, Song; Ashina, Messoud

    2017-01-01

    BACKGROUND: Intravenous infusion of 10 pmol/kg/min pituitary adenylate cyclase-activating polypeptide-38 (PACAP38) induces migraine-like attacks in migraine patients without aura (MO). Here, we conducted a pilot study and investigated if lower doses of PACAP38 exert similar migraine......-inducing abilities. METHODS: We randomly allocated six MO patients to receive intravenous infusion of 4, 6, and 8 pmol/kg/min of PACAP38 over 20 minutes in a double-blind, three-way cross-over study. Headache and migraine characteristics were recorded during hospital (0-2 hours) and post-hospital (2-13 hours) phases....... RESULTS: PACAP38 induced migraine-like attacks in one out of six patients with 4 pmol, two out of six patients with 6 pmol and three out of six patients with 8 pmol (p = 0.368). All patients reported head pain after 8 pmol/kg/min, whereas five of six participants reported head pain after both 4 and 6 pmol...

  5. Treatment diary for botulinum toxin spasticity treatment: a pilot study.

    Science.gov (United States)

    Biering-Sørensen, Bo; Iversen, Helle K; Frederiksen, Inge M S; Vilhelmsen, Jeanet R; Biering-Sørensen, Fin

    2017-02-20

    The aim of this study is to develop a treatment diary for patients receiving spasticity treatment including botulinum toxin injection and physiotherapy and/or occupational therapy. The diary focuses on problems triggered by skeletal muscle overactivity; agreed goals for treatment and the patient's self-evaluation of achievement on the Goal Attainment Scale; which skeletal muscles were injected; physiotherapists' and occupational therapists' evaluation of the patients' achievement of objectives on the Goal Attainment Scale; and proposals for optimization of treatment and changing goals. The evaluation included a satisfaction questionnaire and the WHO-QoL BREF and WHO-5 well-being score. Overall, 10 patients were enrolled in the pilot study. The patients were generally satisfied with the diary, found that it involved them more in their treatment and made it easier to set personal goals, and found it worth the time spent using it. However, no clear advantage in relation to their quality of life (WHO-QoL BREF and WHO-5 well-being score) was reported.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

  6. Patterns of federal Internet offenders: a pilot study.

    Science.gov (United States)

    Burgess, Ann W; Carretta, Carrie M; Burgess, Allen G

    2012-09-01

    Internet-facilitated sexual offending is receiving increased forensic and clinical attention. Two issues confront this field. First, studies are equivocal as to whether (or not) the possession of Internet pornography can escalate to contact sexual offenses against a child, and second, federal judges have been questioning the length of sentences for users only of child pornography. The findings of this pilot study of 101 federal Internet offenders revealed over half of the men at the time of arrest were employed, educated, were in (or had been in) a relationship, had children, and did not have a prior criminal offense, suggesting a changing profile of a convicted sex offender. Forensic and psychiatric nurses who evaluate users of child pornography contraband need to be knowledgeable of Internet file transfer technology and the various types of contraband viewed specifically for the age of the preferred child, extreme acts to the child (e.g., bondage, S&M), and whether the user prefers images of adults with children or images of children only.

  7. Patterns of Sweet Taste Liking: A Pilot Study

    Science.gov (United States)

    Asao, Keiko; Miller, Jason; Arcori, Leann; Lumeng, Julie C.; Han-Markey, Theresa; Herman, William H.

    2015-01-01

    Two distinct patterns of sweet taste liking have been described: one showing a peak liking response in the mid-range of sucrose concentrations and the other showing a monotonic liking response at progressively higher sucrose concentrations. Classification of these patterns has been somewhat arbitrary. In this report, we analyzed patterns of sweet taste liking in a pilot study with 26 adults including 14 women and 12 men, 32.6 ± 14.5 years of age with body mass index 26.4 ± 5.1 kg/m2 (mean ± SD). Sweet taste liking was measured for 10 levels of sucrose solutions (0.035 M to 1.346 M). Participants rated their liking of each solution using a visual analog scale with 0 indicating strongly disliking and 100 strongly liking. The cluster analysis demonstrated two distinct groups: 13 liked relatively low sucrose concentrations and liked high sucrose concentrations less, and 13 liked high sucrose concentrations greatly. If we use the 0.598 M sucrose solution alone and a cutoff liking score of 50, we can distinguish the two clusters with high sensitivity (100%) and specificity (100%). If validated in additional studies, this simple tool may help us to better understand eating behaviors and the impact of sweet taste liking on nutrition-related disorders. PMID:26404363

  8. Patterns of Sweet Taste Liking: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Keiko Asao

    2015-08-01

    Full Text Available Two distinct patterns of sweet taste liking have been described: one showing a peak liking response in the mid-range of sucrose concentrations and the other showing a monotonic liking response at progressively higher sucrose concentrations. Classification of these patterns has been somewhat arbitrary. In this report, we analyzed patterns of sweet taste liking in a pilot study with 26 adults including 14 women and 12 men, 32.6 ± 14.5 years of age with body mass index 26.4 ± 5.1 kg/m2 (mean ± SD. Sweet taste liking was measured for 10 levels of sucrose solutions (0.035 M to 1.346 M. Participants rated their liking of each solution using a visual analog scale with 0 indicating strongly disliking and 100 strongly liking. The cluster analysis demonstrated two distinct groups: 13 liked relatively low sucrose concentrations and liked high sucrose concentrations less, and 13 liked high sucrose concentrations greatly. If we use the 0.598 M sucrose solution alone and a cutoff liking score of 50, we can distinguish the two clusters with high sensitivity (100% and specificity (100%. If validated in additional studies, this simple tool may help us to better understand eating behaviors and the impact of sweet taste liking on nutrition-related disorders.

  9. Mirror therapy in children with hemiplegia: a pilot study.

    Science.gov (United States)

    Gygax, Marine Jequier; Schneider, Patrick; Newman, Christopher John

    2011-05-01

    Mirror therapy, which provides the visual illusion of a functional paretic limb by using the mirror reflection of the non-paretic arm, is used in the rehabilitation of hemiparesis after stroke in adults. We tested the effectiveness and feasibility of mirror therapy in children with hemiplegia by performing a pilot crossover study in ten participants (aged 6-14 y; five males, five females; Manual Ability Classification System levels: one at level I, two at level II, four at level III, three at level IV) randomly assigned to 15 minutes of daily bimanual training with and without a mirror for 3 weeks. Assessments of maximal grasp and pinch strengths, and upper limb function measured by the Shriner's Hospital Upper Extremity Evaluation were performed at weeks 0 (baseline), 3, 6 (intervention), and 9 (wash-out). Testing of grasp strength behind the mirror improved performance by 15% (p=0.004). Training with the mirror significantly improved grasp strength (with mirror +20.4%, p=0.033; without +5.9%, p>0.1) and upper limb dynamic position (with mirror +4.6%, p=0.044; without +1.2%, p>0.1), while training without a mirror significantly improved pinch strength (with mirror +6.9%, p>0.1; without +21.9%, p=0.026). This preliminary study demonstrates the feasibility of mirror therapy in children with hemiplegia and that it may improve strength and dynamic function of the paretic arm.

  10. Effects of a multidisciplinary group rehabilitation programme on participation of the visually impaired elderly : a pilot study

    NARCIS (Netherlands)

    Alma, Manna A.; Groothoff, Johan W.; Melis-Dankers, Bart J. M.; Post, Marcel W. M.; Suurmeijer, Theo P. B. M.; van der Mei, Sijrike F.

    2012-01-01

    Purpose: To pilot test the newly developed multidisciplinary group rehabilitation programme Visually Impaired elderly Persons Participating (VIPP). Method: A single group pretest-posttest design pilot study included 29 visually impaired persons (>= 55 years). The intervention (20 weekly meetings) co

  11. Reducing postpartum weight retention – a pilot trial in primary health care

    Directory of Open Access Journals (Sweden)

    Fogelholm Mikael

    2007-09-01

    Full Text Available Abstract Background Postpartum weight retention may contribute to the development of obesity. We studied whether individual counselling on diet and physical activity from 2 to 10 months postpartum has positive effects on diet and leisure time physical activity and increases the proportion of primiparas returning to their pre-pregnancy weight. Methods A controlled trial including ninety-two postpartum primiparas was conducted in three intervention and three control child health clinics in primary health care in Finland. The intervention included individual counselling on diet and physical activity during five routine visits to a public health nurse; the controls received the usual care. Results In total, 50% of the intervention group and 30% of the control group returned to their pre-pregnancy weight (weight retention ≤ 0 kg by 10 months postpartum (p = 0.06. The confounder-adjusted odds ratio for returning to pre-pregnancy weight was 3.89 (95% CI 1.16–13.04, p = 0.028 for the intervention group compared with the controls. The mean proportion of high-fibre bread (of total weekly amount of bread increased by 16.1% (95% CI 4.3–27.9 by 10 months postpartum in the intervention group compared with the controls when adjusted for confounders (p = 0.008. No significant differences were observed in changes in leisure time physical activity between the groups. Conclusion The intervention increased the proportion of primiparas returning to pre-pregnancy weight and the proportion of high-fibre bread in their diet. Larger randomized controlled trials are needed to show whether counselling can improve dietary and leisure time physical activity habits in postpartum women and also to confirm the results concerning the effect on reducing postpartum weight retention. Trial registration Current Controlled Trials ISRCTN21512277

  12. Setting-up nurse-led pilot clinics for the management of non-communicable diseases at primary health care level in resource-limited settings of Africa

    Directory of Open Access Journals (Sweden)

    Jean-Claude Mbanya

    2009-10-01

    Full Text Available BACKGROUND: This article describes the setting-up process for nurse-led pilot clinics for the management of four chronic diseases: asthma, type 2 diabetes mellitus, epilepsy and hypertension at the primary health care level in urban and rural Cameroon. METHODS: The Biyem-Assi urban and the Bafut rural health districts in Cameroon served as settings for this study. International and local guidelines were identified and adapted to the country's; circumstances. Training and follow-up tools were developed and nurses trained by experienced physicians in the management of the four conditions. Basic diagnostic and follow-up materials were provided and relevant essential drugs made available. RESULTS: Forty six nurses attended six training courses. By the second year of activity, three and four clinics were operational in the urban and the rural areas respectively. By then, 925 patients had been registered in the clinics. This represented a 68.5% increase from the first year. While the rural clinics relied mainly on essential drugs for their prescriptions, a prescription pattern combining generic and proprietary drugs was observed in the urban clinics. CONCLUSION: In the quest for cost-effective health care for NCD in sub-Saharan Africa, rethinking health workforce and service delivery has relevance. Nurse-led clinics, algorithm driven service delivery stands as alternatives to overcome the shortage of trained physicians and other issues relating to access to care.

  13. Repeated hands-and-knees positioning during labour: a randomized pilot study.

    Science.gov (United States)

    Hodnett, Ellen D; Stremler, Robyn; Halpern, Stephen H; Weston, Julie; Windrim, Rory

    2013-01-01

    Background. Caesarean birth rates in North America continue to rise, in the absence of benefit for mothers and babies. One reason may be that hospitalized labouring women spend most of their labours in recumbent or semi-recumbent positions. Although hands-and-knees position has theoretical advantages, efforts to encourage its adoption in practice are severely hampered by the lack of compelling evidence that it is beneficial. Before a definitive, large scale trial, with spontaneous vaginal birth as the primary outcome, could be justified in terms of time, effort, and expense, several feasibility and acceptability questions had to be addressed. We aimed to enrol 60 women in a pilot study to assess feasibility and acceptability of the trial protocol, and to obtain estimates of treatment effects on method of birth and persistent back pain. Methods. We conducted a pilot study at two North American hospitals. In ten months of recruitment, 30 nulliparous women in labour at term were randomly allocated to either usual care (use of any position during labour except hands-and-knees) or to try hands-and-knees for 15 min every hour during labour. Data were collected about compliance, acceptability, persistent back pain, intrapartum interventions, and women's views of their experiences. Results. Although mean length of time from randomization to delivery was over 12 hours, only 9 of the 16 women allocated to repeated hands-and-knees used it more than twice. Two of the 14 in the usual care group used hands-and-knees once. Twenty-seven women had regional analgesia (15 in the hands-and-knees group and 12 in the usual care group). Eleven in the hands-and-knees group and 14 in the usual care group had spontaneous vaginal births. One woman (in the hands-and-knees group) had a vacuum extraction. Four women in the hands-and-knees group and none in the usual care group gave birth by caesarean section. Hourly back pain ratings were highly variable in both groups, covering the full range

  14. Repeated hands-and-knees positioning during labour: a randomized pilot study

    Directory of Open Access Journals (Sweden)

    Ellen D. Hodnett

    2013-02-01

    Full Text Available Background. Caesarean birth rates in North America continue to rise, in the absence of benefit for mothers and babies. One reason may be that hospitalized labouring women spend most of their labours in recumbent or semi-recumbent positions. Although hands-and-knees position has theoretical advantages, efforts to encourage its adoption in practice are severely hampered by the lack of compelling evidence that it is beneficial. Before a definitive, large scale trial, with spontaneous vaginal birth as the primary outcome, could be justified in terms of time, effort, and expense, several feasibility and acceptability questions had to be addressed. We aimed to enrol 60 women in a pilot study to assess feasibility and acceptability of the trial protocol, and to obtain estimates of treatment effects on method of birth and persistent back pain.Methods. We conducted a pilot study at two North American hospitals. In ten months of recruitment, 30 nulliparous women in labour at term were randomly allocated to either usual care (use of any position during labour except hands-and-knees or to try hands-and-knees for 15 min every hour during labour. Data were collected about compliance, acceptability, persistent back pain, intrapartum interventions, and women’s views of their experiences.Results. Although mean length of time from randomization to delivery was over 12 hours, only 9 of the 16 women allocated to repeated hands-and-knees used it more than twice. Two of the 14 in the usual care group used hands-and-knees once. Twenty-seven women had regional analgesia (15 in the hands-and-knees group and 12 in the usual care group. Eleven in the hands-and-knees group and 14 in the usual care group had spontaneous vaginal births. One woman (in the hands-and-knees group had a vacuum extraction. Four women in the hands-and-knees group and none in the usual care group gave birth by caesarean section. Hourly back pain ratings were highly variable in both groups

  15. Arctic Ice Dynamics Joint Experiment (AIDJEX) Second Pilot Study, March - May 1972: A Documentary Film

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The project described in this documentary was a pilot study conducted in 1972 in preparation for the AIDJEX main experiment of 1975 to 1976. The study included a...

  16. Mobile Health Care over 3G Networks: the MobiHealth Pilot System and Service

    NARCIS (Netherlands)

    Wac, Katarzyna; Bults, Richard; Konstantas, Dimitri; Halteren, van Aart; Jones, Val; Widya, Ing; Herzog, Rainer

    2004-01-01

    Health care is one of the most prominent areas for the application of wireless technologies. New services and applications are today under research and development targeting different areas of health care, from high risk and chronic patients’ remote monitoring to mobility tools for the medical perso

  17. Preoperative home-based physical therapy versus usual care to improve functional health of frail older adults scheduled for elective total hip arthroplasty: A pilot randomized controlled trial

    NARCIS (Netherlands)

    Oosting, E.; Jans, M.P.; Dronkers, J.J.; Naber, R.H.; Dronkers-Landman, C.M.; Appelman-De Vries, S.M.; Meeteren, N.L. van

    2012-01-01

    Preoperative home-based physical therapy versus usual care to improve functional health of frail older adults scheduled for elective total hip arthroplasty: a pilot randomized controlled trial. Objective: To investigate the feasibility and preliminary effectiveness of a home-based intensive exercise

  18. Implementation of a Cardiovascular Disease Prevention Program among School-Aged Children: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Lavon Young

    2006-09-01

    Full Text Available The objective of this study was to test students’ knowledge of cardiovascular disease information and to determine if a carefully structured training program administered to high school students would increase their knowledge about cardiovascular disease and risk factors that are preventable. A pilot study was conducted during which fifty high school students from nine counties in the State of Mississippi were measured for their knowledge of hypertension both at baseline and after the completion of an intervention training activity. There were significant gains in knowledge between the pre-test and the post-test that the students completed. The gains in knowledge indicate that elimination of risk factors is possible if all health care and school-based prevention programs are implemented to positively impact changes in eating and physical activity behaviors. Students’ involvement in such activities could translate into significant changes in risk factors at these ages and throughout their lifetime. It is widely accepted that these behavioral changes, if sustained into adulthood, could have the potential to influence cardiovascular risk reduction.

  19. Elder abuse and dementia--a pilot study.

    Science.gov (United States)

    Cooney, C; Mortimer, A

    1995-01-01

    An anonymous postal questionnaire was distributed to 200 members of a voluntary organisation providing information and support for the carers of dementia sufferers. Carers were asked about the possible occurrence of verbal, physical abuse and neglect. Those carers who admitted to any form of abuse were compared with those who did not and risk factors in both carers and patients were analysed to determine risk factors for abuse. Fifty-five per cent of carers admitted to some form of abuse with verbal abuse being the most common form. Verbal abuse was associated with a poor premorbid relationship and social isolation of the carer and was found to be a risk factor for physical abuse. Those carers who had high GHQ scores and who had been caring for longer were more likely to physically abuse the person they cared for. This study supports the hypothesis that various categories of abuse have different correlates.

  20. Gene Expression Correlation for Cancer Diagnosis: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Binbing Ling

    2014-01-01

    Full Text Available Poor prognosis for late-stage, high-grade, and recurrent cancers has been motivating cancer researchers to search for more efficient biomarkers to identify the onset of cancer. Recent advances in constructing and dynamically analyzing biomolecular networks for different types of cancer have provided a promising novel strategy to detect tumorigenesis and metastasis. The observation of different biomolecular networks associated with normal and cancerous states led us to hypothesize that correlations for gene expressions could serve as valid indicators of early cancer development. In this pilot study, we tested our hypothesis by examining whether the mRNA expressions of three randomly selected cancer-related genes PIK3C3, PIM3, and PTEN were correlated during cancer progression and the correlation coefficients could be used for cancer diagnosis. Strong correlations (0.68≤r≤1.0 were observed between PIK3C3 and PIM3 in breast cancer, between PIK3C3 and PTEN in breast and ovary cancers, and between PIM3 and PTEN in breast, kidney, liver, and thyroid cancers during disease progression, implicating that the correlations for cancer network gene expressions could serve as a supplement to current clinical biomarkers, such as cancer antigens, for early cancer diagnosis.

  1. Perceived harmfulness of substance use: A pilot study

    Directory of Open Access Journals (Sweden)

    Siddharth Sarkar

    2014-01-01

    Full Text Available Background: Harm ratings of substances help in understanding the perception toward substance use and formulating policies. Evidence of such harm ratings by substance users and their caregivers provides a clearer perspective of those who experience and observe such harm closely. Materials and Methods: Substance users and their caregivers were recruited from the Drug De-addiction and Treatment Centre of PGIMER, Chandigarh. Sociodemographic details of the subjects were noted. The subjects were then asked to rate a list of psychoactive preparations according to the harms they thought the preparation caused. The list of substances was developed taking into consideration substance commonly encountered in the geographical area. The harm ratings were transformed on a scale of 0-100. Results: All subjects were males and majority of them were educated above 10 th standard, were not employed and belonged to urban background. Most of them had taken psychoactive substances in their lifetimes but were currently abstinent. Most of the subjects endorsed intravenous drugs as the most harmful, followed by heroin. Beer and chewable tobacco considered the least harmful substances. Greater degree of education was associated with lower harm rankings for heroin, cannabis, dextropropoxyphene, and raw opium; while urban residence was associated with greater harm ratings for cannabis and raw opium. Differences in the harms were perceived for different preparations of the same active compound for alcohol and nicotine. Conclusion: Harm ratings of substances can be a useful guide while formulating policies and allocating resources. Need for further research extending this pilot study is emphasized.

  2. Skin and plasma autofluorescence during hemodialysis: a pilot study.

    Science.gov (United States)

    Graaff, Reindert; Arsov, Stefan; Ramsauer, Bernd; Koetsier, Marten; Sundvall, Nils; Engels, Gerwin E; Sikole, Aleksandar; Lundberg, Lennart; Rakhorst, Gerhard; Stegmayr, Bernd

    2014-06-01

    Skin autofluorescence (AF) is related to the accumulation of advanced glycation end products (AGEs) and is one of the strongest prognostic markers of mortality in hemodialysis (HD) patients. The aim of this pilot study was to investigate whether changes in skin AF appear after a single HD session and if they might be related to changes in plasma AF. Skin and plasma AF were measured before and after HD in 35 patients on maintenance HD therapy (nine women and 26 men, median age 68 years, range 33-83). Median dialysis time was 4 h (range 3-5.5). Skin AF was measured noninvasively with an AGE Reader, and plasma AF was measured before and after HD at 460 nm after excitation at 370 nm. The HD patients had on average a 65% higher skin AF value than age-matched healthy persons (P < 0.001). Plasma AF was reduced by 14% (P < 0.001), whereas skin AF was not changed after a single HD treatment. No significant influence of the reduced plasma AF on skin AF levels was found. This suggests that the measurement of skin AF can be performed during the whole dialysis period and is not directly influenced by the changes in plasma AF during HD.

  3. Microwave Imaging of Human Forearms: Pilot Study and Image Enhancement

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    Colin Gilmore

    2013-01-01

    Full Text Available We present a pilot study using a microwave tomography system in which we image the forearms of 5 adult male and female volunteers between the ages of 30 and 48. Microwave scattering data were collected at 0.8 to 1.2 GHz with 24 transmitting and receiving antennas located in a matching fluid of deionized water and table salt. Inversion of the microwave data was performed with a balanced version of the multiplicative-regularized contrast source inversion algorithm formulated using the finite-element method (FEM-CSI. T1-weighted MRI images of each volunteer’s forearm were also collected in the same plane as the microwave scattering experiment. Initial “blind” imaging results from the utilized inversion algorithm show that the image quality is dependent on the thickness of the arm’s peripheral adipose tissue layer; thicker layers of adipose tissue lead to poorer overall image quality. Due to the exible nature of the FEM-CSI algorithm used, prior information can be readily incorporated into the microwave imaging inversion process. We show that by introducing prior information into the FEM-CSI algorithm the internal anatomical features of all the arms are resolved, significantly improving the images. The prior information was estimated manually from the blind inversions using an ad hoc procedure.

  4. A Problem Solving Intervention for hospice caregivers: a pilot study.

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    Demiris, George; Oliver, Debra Parker; Washington, Karla; Fruehling, Lynne Thomas; Haggarty-Robbins, Donna; Doorenbos, Ardith; Wechkin, Hope; Berry, Donna

    2010-08-01

    The Problem Solving Intervention (PSI) is a structured, cognitive-behavioral intervention that provides people with problem-solving coping skills to help them face major negative life events and daily challenges. PSI has been applied to numerous settings but remains largely unexplored in the hospice setting. The aim of this pilot study was to demonstrate the feasibility of PSI targeting informal caregivers of hospice patients. We enrolled hospice caregivers who were receiving outpatient services from two hospice agencies. The intervention included three visits by a research team member. The agenda for each visit was informed by the problem-solving theoretical framework and was customized based on the most pressing problems identified by the caregivers. We enrolled 29 caregivers. Patient's pain was the most frequently identified problem. On average, caregivers reported a higher quality of life and lower level of anxiety postintervention than at baseline. An examination of the caregiver reaction assessment showed an increase of positive esteem average and a decrease of the average value of lack of family support, impact on finances, impact on schedules, and on health. After completing the intervention, caregivers reported lower levels of anxiety, improved problem solving skills, and a reduced negative impact of caregiving. Furthermore, caregivers reported high levels of satisfaction with the intervention, perceiving it as a platform to articulate their challenges and develop a plan to address them. Findings demonstrate the value of problem solving as a psycho-educational intervention in the hospice setting and call for further research in this area.

  5. Sociomoral Reasoning in Adults with ADHD: A Pilot Study

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    Kate E. Thomason

    2014-08-01

    Full Text Available Attention Deficit Hyperactivity Disorder (ADHD is frequently linked with antisocial behaviour, yet less is known about its relationship with sociomoral reasoning, and the possible mediating effect of intelligence. A pilot study was designed to investigate the relationship between antisocial personality traits, intelligence and sociomoral reasoning in adults with ADHD. Twenty two adults with ADHD and 21 healthy controls, matched for age, gender and IQ completed a battery of measures including the National Adult Reading Test, Gough Socialisation Scale and Sociomoral Reflection Measure-Short Form. There was no difference between the groups and levels of sociomoral reasoning, despite the ADHD group reporting greater antisocial personality traits. Sociomoral reasoning was positively correlated with intelligence. Results from a hierarchical multiple regressions indicated that both antisocial traits and IQ were significant predictors of sociomoral reasoning, with IQ proving the most powerful predictor. Whilst antisocial personality traits may explain some of the variance in levels of sociomoral reasoning, a diagnosis of ADHD does not appear to hinder the development of mature moral reasoning. Intellectual functioning appears to facilitate the development of sociomoral reasoning. A further analysis showed that both ADHD and low sociomoral reasoning were significant predictors of antisocial traits. The current findings have important treatment implications.

  6. Adjustable recessions in horizontal comitant strabismus: A pilot study

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    Siddharth Agrawal

    2015-01-01

    Full Text Available Aim: To compare the surgical outcome of adjustable with the conventional recession in patients with horizontal comitant strabismus. Patients and Methods: A prospective comparative nonrandomized interventional pilot study was performed on patients with horizontal comitant strabismus. Fifty-four patients (27 in each group were allocated into 2 groups to undergo either adjustable suture (AS recession or non-AS (NAS recession along with conventional resection. The patients were followed up for 6 months. A successful outcome was defined as deviation ±10 prism diopters at 6 months. The results were statistically analyzed by Chi-square test, Fisher′s exact test, and Student′s t-test. Results: A successful outcome was found in 24 (88.8% patients in AS and 17 (62.9% in NAS group (P = 0.02. The postoperative adjustment was done in 13 (48.1% patients in AS group. There was one complication (tenon′s cyst in AS group. Conclusion: AS recession may be considered in all cooperative patients undergoing strabismus surgery for comitant deviations.

  7. Technical efficiency of public district hospitals and health centres in Ghana: a pilot study

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    Kirigia Joses M

    2005-09-01

    Full Text Available Abstract Background The Government of Ghana has been implementing various health sector reforms (e.g. user fees in public health facilities, decentralization, sector-wide approaches to donor coordination in a bid to improve efficiency in health care. However, to date, except for the pilot study reported in this paper, no attempt has been made to make an estimate of the efficiency of hospitals and/or health centres in Ghana. The objectives of this study, based on data collected in 2000, were: (i to estimate the relative technical efficiency (TE and scale efficiency (SE of a sample of public hospitals and health centres in Ghana; and (ii to demonstrate policy implications for health sector policy-makers. Methods The Data Envelopment Analysis (DEA approach was used to estimate the efficiency of 17 district hospitals and 17 health centres. This was an exploratory study. Results Eight (47% hospitals were technically inefficient, with an average TE score of 61% and a standard deviation (STD of 12%. Ten (59% hospitals were scale inefficient, manifesting an average SE of 81% (STD = 25%. Out of the 17 health centres, 3 (18% were technically inefficient, with a mean TE score of 49% (STD = 27%. Eight health centres (47% were scale inefficient, with an average SE score of 84% (STD = 16%. Conclusion This pilot study demonstrated to policy-makers the versatility of DEA in measuring inefficiencies among individual facilities and inputs. There is a need for the Planning and Budgeting Unit of the Ghana Health Services to continually monitor the productivity growth, allocative efficiency and technical efficiency of all its health facilities (hospitals and health centres in the course of the implementation of health sector reforms.

  8. Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework.

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    Eldridge, Sandra M; Lancaster, Gillian A; Campbell, Michael J; Thabane, Lehana; Hopewell, Sally; Coleman, Claire L; Bond, Christine M

    2016-01-01

    We describe a framework for defining pilot and feasibility studies focusing on studies conducted in preparation for a randomised controlled trial. To develop the framework, we undertook a Delphi survey; ran an open meeting at a trial methodology conference; conducted a review of definitions outside the health research context; consulted experts at an international consensus meeting; and reviewed 27 empirical pilot or feasibility studies. We initially adopted mutually exclusive definitions of pilot and feasibility studies. However, some Delphi survey respondents and the majority of open meeting attendees disagreed with the idea of mutually exclusive definitions. Their viewpoint was supported by definitions outside the health research context, the use of the terms 'pilot' and 'feasibility' in the literature, and participants at the international consensus meeting. In our framework, pilot studies are a subset of feasibility studies, rather than the two being mutually exclusive. A feasibility study asks whether something can be done, should we proceed with it, and if so, how. A pilot study asks the same questions but also has a specific design feature: in a pilot study a future study, or part of a future study, is conducted on a smaller scale. We suggest that to facilitate their identification, these studies should be clearly identified using the terms 'feasibility' or 'pilot' as appropriate. This should include feasibility studies that are largely qualitative; we found these difficult to identify in electronic searches because researchers rarely used the term 'feasibility' in the title or abstract of such studies. Investigators should also report appropriate objectives and methods related to feasibility; and give clear confirmation that their study is in preparation for a future randomised controlled trial designed to assess the effect of an intervention.

  9. Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework.

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    Sandra M Eldridge

    Full Text Available We describe a framework for defining pilot and feasibility studies focusing on studies conducted in preparation for a randomised controlled trial. To develop the framework, we undertook a Delphi survey; ran an open meeting at a trial methodology conference; conducted a review of definitions outside the health research context; consulted experts at an international consensus meeting; and reviewed 27 empirical pilot or feasibility studies. We initially adopted mutually exclusive definitions of pilot and feasibility studies. However, some Delphi survey respondents and the majority of open meeting attendees disagreed with the idea of mutually exclusive definitions. Their viewpoint was supported by definitions outside the health research context, the use of the terms 'pilot' and 'feasibility' in the literature, and participants at the international consensus meeting. In our framework, pilot studies are a subset of feasibility studies, rather than the two being mutually exclusive. A feasibility study asks whether something can be done, should we proceed with it, and if so, how. A pilot study asks the same questions but also has a specific design feature: in a pilot study a future study, or part of a future study, is conducted on a smaller scale. We suggest that to facilitate their identification, these studies should be clearly identified using the terms 'feasibility' or 'pilot' as appropriate. This should include feasibility studies that are largely qualitative; we found these difficult to identify in electronic searches because researchers rarely used the term 'feasibility' in the title or abstract of such studies. Investigators should also report appropriate objectives and methods related to feasibility; and give clear confirmation that their study is in preparation for a future randomised controlled trial designed to assess the effect of an intervention.

  10. Probabilistic Tsunami Hazard Assessment: the Seaside, Oregon Pilot Study

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    Gonzalez, F. I.; Geist, E. L.; Synolakis, C.; Titov, V. V.

    2004-12-01

    A pilot study of Seaside, Oregon is underway, to develop methodologies for probabilistic tsunami hazard assessments that can be incorporated into Flood Insurance Rate Maps (FIRMs) developed by FEMA's National Flood Insurance Program (NFIP). Current NFIP guidelines for tsunami hazard assessment rely on the science, technology and methodologies developed in the 1970s; although generally regarded as groundbreaking and state-of-the-art for its time, this approach is now superseded by modern methods that reflect substantial advances in tsunami research achieved in the last two decades. In particular, post-1990 technical advances include: improvements in tsunami source specification; improved tsunami inundation models; better computational grids by virtue of improved bathymetric and topographic databases; a larger database of long-term paleoseismic and paleotsunami records and short-term, historical earthquake and tsunami records that can be exploited to develop improved probabilistic methodologies; better understanding of earthquake recurrence and probability models. The NOAA-led U.S. National Tsunami Hazard Mitigation Program (NTHMP), in partnership with FEMA, USGS, NSF and Emergency Management and Geotechnical agencies of the five Pacific States, incorporates these advances into site-specific tsunami hazard assessments for coastal communities in Alaska, California, Hawaii, Oregon and Washington. NTHMP hazard assessment efforts currently focus on developing deterministic, "credible worst-case" scenarios that provide valuable guidance for hazard mitigation and emergency management. The NFIP focus, on the other hand, is on actuarial needs that require probabilistic hazard assessments such as those that characterize 100- and 500-year flooding events. There are clearly overlaps in NFIP and NTHMP objectives. NTHMP worst-case scenario assessments that include an estimated probability of occurrence could benefit the NFIP; NFIP probabilistic assessments of 100- and 500-yr

  11. Evaluating the feasibility and effectiveness of a critical care discharge information pack for patients and their families: a pilot cluster randomised controlled trial

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    Bench, Suzanne; Day, Tina; Heelas, Karina; Hopkins, Philip; White, Catherine; Griffiths, Peter

    2015-01-01

    Objectives To evaluate the feasibility and effectiveness of an information pack, based on self-regulation theory, designed to support patients and their families immediately before, during and after discharge from an intensive care unit (ICU). Design and setting Prospective assessor-blinded pilot cluster randomised controlled trial (RCT; in conjunction with a questionnaire survey of trial participants’ experience) in 2 ICUs in England. Participants Patients (+/− a family member) who had spent at least 72 h in an ICU, declared medically fit for discharge to a general ward. Randomisation Cluster randomisation (by day of discharge decision) was used to allocate participants to 1 of 3 study groups. Intervention A user-centred critical care discharge information pack (UCCDIP) containing 2 booklets; 1 for the patient (which included a personalised discharge summary) and 1 for the family, given prior to discharge to the ward. Primary outcome Psychological well-being measured using Hospital Anxiety and Depression Scores (HADS), assessed at 5±1 days postunit discharge and 28 days/hospital discharge. Statistical significance (p≤0.05) was determined using χ2 and Kruskal-Wallis (H). Results 158 patients were allocated to: intervention (UCCDIP; n=51), control 1: ad hoc verbal information (n=59), control 2: booklet published by ICUsteps (n=48). There were no statistically significant differences in the primary outcome. The a priori enrolment goal was not reached and attrition was high. Using HADS as a primary outcome measure, an estimated sample size of 286 is required to power a definitive trial. Conclusions Findings from this pilot RCT provide important preliminary data regarding the circumstances under which an intervention based on the principles of UCCDIP could be effective, and the sample size required to demonstrate this. Trial registration number Current Controlled Trials ISRCTN47262088; results. PMID:26614615

  12. [Vitalink: a digital platform to share patient health records in primary care. Report of the pilot projects for sharing medication schemes].

    Science.gov (United States)

    Zwaenepoel, L; Hulshagen, L

    2014-03-01

    Vitalink is a digital platform to share health patient data among health care professionals in primary care. The Flemish community started the development of this platform in collaboration with representatives of professional associations primary care. Sharing medication charts online was the first Vitalink project. In December 2012 four pilot regions in Flanders (Turnhout, Limburg, Aalst and Halle) tested medication chart sharing through Vitalink. Due to difficulties with software development effective sharing started only in April 2013. The test phase was ended in October 2013. Each pilot region made an evaluation report. Conclusions were similar: the realization business cases were limited. Integration in end user software was insufficiently performant. Moreover, interpretation of downloaded medication charts was found out to differ among participating software applications. Because of these problems exchange of patient records among primary care actors was limited. Therefore research questions could not be conclusively answered. Nevertheless the Vitalink pilot project can be considered successful in some ways. Collaboration and communication among health care professionals and their associations was ameliorated. The awareness of digital data sharing in primary care is growing. Pilot projects created buy in among patients, physicians, pharmacists and nurses. Uniform lay-out guidelines were established in deliberation with all participating actors. Since November 2013 Vitalink is in production. Medication charts, summarized electronic health records and vaccination data can be uploaded to the platform and health care professionals that are registered can consult them. End user software must still be developed to make broad use of the platform feasible. Meanwhile further deliberation with software vendors and professional associations can be organized in order to achieve the implementation and integration of user friendly Vitalink modules.

  13. Pilot Evaluation Study of the Life Skills Program REBOUND

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    Henrik Jungaberle

    2015-11-01

    Full Text Available The main aim of the study is pilot evaluation of the life skills program REBOUND in a school context focusing on substance use, risk perception, and knowledge about psychoactive substances ( n IG + CG = 723 students in five schools and 46 classes, Mage = 14.8, range 14-18 for the total sample and in the subgroups gender, age, and school type. Main goal of the study is collecting evidence for program optimization. A controlled study was carried out with repeated measurement before and after the intervention (4-6 months. Multilevel analyses, ANCOVA, and logistic regression analyses were applied to measure the effects. Overall, significantly lower incidence rates of drunkenness (odds ratio [OR] = .55; p = .033, improved knowledge about psychoactive substances (p = .006, lower personal (p = .013 and general tobacco risk perception among users (p = .002, and lower general tobacco (p = .018 and cannabis (p = .000 risk perception in non-users were found in the total intervention group. In subgroups, significantly lower rates for the incidence of drunkenness can be shown for males (p = .008 and for younger participants (p = .004. Students at academic high school (German Gymnasium showed a decrease in 30-day prevalence for alcohol (p = .017 and cannabis (p = .014, and they improved in their knowledge about psychoactive substances (p = .000. In vocational high school classes (German Realschule, there was an increase in the relative alcohol risk perception of the students (p = .019. REBOUND contributes to a controlled use of alcohol and increases knowledge about psychoactive substances. REBOUND has various effects on the examined subgroups age, gender, and school type: Males, younger students, and students in academic high school benefitted more from the course regarding consumption-related criteria. We suggest a program optimization specific to school form and age, inclusion of a tobacco intervention, and the use of more gender-segregated interventions.

  14. Screening Preschool Children for Visual Disorders: A Pilot Study

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    Suman Adhikari, BOptom

    2013-12-01

    Full Text Available Purpose: Ocular and/or vision defects are one of the most common reasons for the referral of young children to the hospital. Vision disorders are the fourth most common disability of children and the leading cause of handicapping conditions in childhood. In preschool-age children, amblyopia and amblyogenic risk factors, such as strabismus and significant refractive errors, are the most prevalent and important visual disorders. The purpose of this pilot study was to determine the prevalence of visual disorders in preschool children in Kathmandu Valley, Nepal.Methods: Four hundred and eighty-four children attending eight preschools in Kathmandu Valley underwent detailed optometric examination. Visual acuity was assessed with either Sheridan Gardiner or Kay Picture chart monocularly. Binocularity was assessed with cover test and prism bar neutralisation. Refraction was carried out in all children. In most instances this was done without the use of a cycloplegic agent. Stereopsis was assessed with the Lang stereo test. Anterior and posterior segment abnormalities were assessed by using a pen light, hand-held slit lamp, and direct ophthalmoscope.Results: Refractive error was the most common visual disorder. Considering our criteria of refractive error for myopia ≥ 0.50 D, hyperopia ≥ 1.50 D, astigmatism ≥ 1.00 D, and anisometropia ≥ 1.00 D, the overall prevalence of refractive error in our study was 31.82%. The overall prevalence of myopia, hyperopia, and astigmatism was 24.17%, 2.48%, and 5.17%, respectively. Anisometropia was present in 1.65% of the participants, and 2%, 1.4%, and 0.2% had strabismus, amblyopia, and nystagmus, respectively.Conclusion: The relatively high prevalence of refractive error in our studied population needs more attention. The results suggest that there is a need for a large-scale community-based preschool screening program in Nepal so that affected children can be identified early and appropriate treatment can be

  15. Absorbent alginate fibres modified with hydrolysed chitosan for wound care dressings--II. Pilot scale development.

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    Sweeney, I R; Miraftab, M; Collyer, G

    2014-02-15

    Fibres have been used extensively in wound dressing applications as they provide a high surface area for absorption, ease of fabrication and softness. It is common practice for commercial wound dressings to be produced from natural materials, such a marine polysaccharides, as they are predominantly biocompatible, non-toxic, and often display bioactive properties, such as inherent antimicrobial activity. In this study hydrolysed chitosans were utilised as a sole coagulant for the production of alginate-chitosan fibres via a one-step, direct wet-spinning extrusion process. The levels of chitosan incorporated into the fibres were analysed quantitatively via elemental analysis and qualitatively by staining using Amido Black 10B. It was estimated that the fibres contained between 4.50 and 5.10% (wt.%) chitosan. The presence of chitosan improved tensile properties such as elongation and tenacity of the base alginate fibres. The increased incorporation of chitosan into the fibres also improved the absorption of the fibres in both saline and distilled water; reaching maximum of >30 g/g and >50 g/g, respectively. This work suggests that the observed hydrolysed chitosan content within the fibre may be optimal for the preparation of a novel fibre for wound care application.

  16. Childhood Obesity Study: A Pilot Study of the Effect of the Nutrition Education Program "Color My Pyramid"

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    Moore, Jean Burley; Pawloski, Lisa Renee; Goldberg, Patricia; Oh, Kyeung Mi; Stoehr, Ana; Baghi, Heibatollah

    2009-01-01

    The need for successful nutrition interventions is critical as the prevalence of childhood obesity increases. Thus, this pilot project examines the effect of a nutrition education program, "Color My Pyramid", on children's nutrition knowledge, self-care practices, activity levels, and nutrition status. Using a pretest-posttest,…

  17. Childhood Obesity Study: A Pilot Study of the Effect of the Nutrition Education Program "Color My Pyramid"

    Science.gov (United States)

    Moore, Jean Burley; Pawloski, Lisa Renee; Goldberg, Patricia; Oh, Kyeung Mi; Stoehr, Ana; Baghi, Heibatollah

    2009-01-01

    The need for successful nutrition interventions is critical as the prevalence of childhood obesity increases. Thus, this pilot project examines the effect of a nutrition education program, "Color My Pyramid", on children's nutrition knowledge, self-care practices, activity levels, and nutrition status. Using a pretest-posttest, quasiexperimental…

  18. Feasibility of the Dutch ICF Activity Inventory: a pilot study

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    van Nispen Ruth MA

    2010-11-01

    Full Text Available Abstract Background Demographic ageing will lead to increasing pressure on visual rehabilitation services, which need to be efficiently organised in the near future. The Dutch ICF Activity Inventory (D-AI was developed to assess the rehabilitation needs of visually impaired persons. This pilot study tests the feasibility of the D-AI using a computer-assisted telephone interview. Methods In addition to the regular intake, the first version of the D-AI was assessed in 20 patients. Subsequently, patients and intake assessors were asked to fill in an evaluation form. Based on these evaluations, a new version of the D-AI was developed. Results Mean administration time of the D-AI was 88.8 (± 41.0 minutes. Overall, patients and assessors were positive about the D-AI assessment. However, professionals and 60% of the patients found the administration time to be too long. All included items were considered relevant and only minor adjustments were recommended. Conclusion The systematic character of the revised D-AI will prevent topics from being overlooked and indicate which needs have the highest priority from a patient-centred perspective. Moreover, ongoing assessment of the D-AI will enhance evaluation of the rehabilitation process. To decrease administration time, in the revised D-AI only the top priority goals will be fully assessed. Using the D-AI, a rehabilitation plan based on individual needs can be developed for each patient. Moreover, it enables better evaluation of the effects of rehabilitation. A larger validation study is planned.

  19. Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study

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    2006-01-01

    Full Text Available Objective. To obtain pilot data on the endometrial histology of Depomedroxyprogesterone acetate (Depo-Provera, DMPA users experiencing breakthrough bleeding (BTB versus users with amenorrhea. To compare the endometrial histology of patients who used DMPA continuously for 3–12 months versus those who used it for 13 months or more. Methods. Cross-sectional study. Endometrial biopsy was obtained from all consenting patients who used DMPA for at least 3 months. Patients were divided into those with BTB in the last 3 months versus those with amenorrhea for at least 3 months. Histology results and duration of therapy were compared. Results. The proportion of women with chronic endometritis, uterine polyps, atrophic, proliferative, or progesterone-dominant endometrium did not differ between those DMPA users with BTB versus those with amenorrhea. Duration of therapy did not correlate with symptoms of BTB or endometrial histology. Chronic endometritis was the most common histologic finding (10/40, 25% and occurred more often in women experiencing BTB (35% versus 15% (RR 1.62 CI 0.91–2.87. Moreover, 45% of women with BTB had received DMPA for more than 12 months. Conclusions. BTB was more common than previously reported in women using DMPA for more than 12 months. Chronic endometritis, which may indicate an underlying infectious or intracavitary anatomic etiology, has not been previously reported as a frequent finding in DMPA users, and may be related to ethnic or other sociodemographic characteristics of our patient population. Further study to elucidate the etiology of chronic endometritis in these patients is warranted.

  20. Effect of Piroxicam on ART Outcome: A Pilot Study

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    Farnaz Sohrabvand

    2014-11-01

    Full Text Available Background: One of the most important factors affecting success rates in assisted reproductive techniques (ART besides the number of oocytes retrieved and high quality embryos derived from them is the technical aspects of embryo transfer. It seems that pretreatement with uterine relaxants can be helpful in preventing unpleasant cramps which can have an adverse effect on ART outcome. In this respect, some drugs such as prostaglandin inhibitors or sedatives have been evaluated but not confirmed yet remain controversial. This study was performed in order to assess the effect of administrating Piroxicam prior to embryo transfer on pregnancy rates in ART cycles. Materials and Methods: This pilot study was performed from August 2010 through December 2011 on 50 infertile women in ART cycles. Recombinant follicle stimulating hormone (rFSH with a long gonadotropin releasing hormone (GnRH analogue protocol were used for controlled ovarian hyperstimulation. The subjects were randomly allocated into two groups of 25 patients after obtaining written consent. Group A received a 10 mg Piroxicam capsule 30 minutes before embryo transfer and group B was the control group with no treatment. Data were analyzed by Chi-square and analysis of variance (ANOVA. Results: Pregnancy rate was 34% (n=17 totally, with 32% (n=8 in group A and 36% (n=9 in group B (p=0.75. Uterine cramps were experienced by 4 women (16% in group B, while none were reported by women in group A (p=0.037. Conclusion: It seems that Piroxicam administration 30 minutes prior to embryo transfer cannot increase pregnancy rates, but can prevent or reduce uterine cramps after the procedure.

  1. Problematic internet usage in US college students: a pilot study

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    Myaing Mon T

    2011-06-01

    Full Text Available Abstract Background Internet addiction among US college students remains a concern, but robust estimates of its prevalence are lacking. Methods We conducted a pilot survey of 307 college students at two US universities. Participants completed the Internet Addiction Test (IAT as well as the Patient Health Questionnaire. Both are validated measures of problematic Internet usage and depression, respectively. We assessed the association between problematic Internet usage and moderate to severe depression using a modified Poisson regression approach. In addition, we examined the associations between individual items in the IAT and depression. Results A total of 224 eligible respondents completed the survey (73% response rate. Overall, 4% of students scored in the occasionally problematic or addicted range on the IAT, and 12% had moderate to severe depression. Endorsement of individual problematic usage items ranged from 1% to 70%. In the regression analysis, depressive symptoms were significantly associated with several individual items. Relative risk could not be estimated for three of the twenty items because of small cell sizes. Of the remaining 17 items, depressive symptoms were significantly associated with 13 of them, and three others had P values less than 0.10. There was also a significant association between problematic Internet usage overall and moderate to severe depression (relative risk 24.07, 95% confidence interval 3.95 to 146.69; P = 0.001. Conclusion The prevalence of problematic Internet usage among US college students is a cause for concern, and potentially requires intervention and treatment amongst the most vulnerable groups. The prevalence reported in this study is lower than that which has been reported in other studies, however the at-risk population is very high and preventative measures are also recommended.

  2. Leading teams during simulated pediatric emergencies: a pilot study

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    Coolen EH

    2015-01-01

    Full Text Available Ester H Coolen,1 Jos M Draaisma,2 Sabien den Hamer,3 Jan L Loeffen2 1Department of Pediatric Surgery, Amalia Children’s Hospital, Radboud University Medical Center, 2Department of Pediatrics, Amalia Children’s Hospital, Radboud University Medical Center, 3Department of Communication Science, Radboud University, Nijmegen, the Netherlands Purpose: Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often report having little opportunity to perform in the role of team leader during residency. In order to gain more insight into leadership skills and behaviors, we classified leadership styles of pediatric residents during simulated emergencies. Methods: We conducted a prospective quantitative study to investigate leadership styles used by pediatric residents during simulated emergencies with clinical deterioration of a child at a pediatric ward. Using videotaped scenarios of 48 simulated critical events among 12 residents, we were able to classify verbal and nonverbal communication into different leadership styles according to the situational leadership theory. Results: The coaching style (mean 54.5%, SD 7.8 is the most frequently applied by residents, followed by the directing style (mean 35.6%, SD 4.1. This pattern conforms to the task- and role-related requirements in our scenarios and it also conforms to the concept of situational leadership. We did not find any significant differences in leadership style according to the postgraduate year or scenario content. Conclusion: The model used in this pilot study helps us to gain a better understanding of the development of effective leadership behavior and supports the applicability of situational leadership theory in training leadership skills during residency. Keywords

  3. Prioritization strategies in clinical practice guidelines development: a pilot study

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    Torres Marcela

    2010-03-01

    Full Text Available Abstract Objective Few methodological studies address the prioritization of clinical topics for the development of Clinical Practice Guidelines (CPGs. The aim of this study was to validate a methodology for Priority Determination of Topics (PDT of CPGs. Methods and results Firstly, we developed an instrument for PDT with 41 criteria that were grouped under 10 domains, based on a comprehensive systematic search. Secondly, we performed a survey of stakeholders involved in CPGs development, and end users of guidelines, using the instrument. Thirdly, a pilot testing of the PDT procedure was performed in order to choose 10 guideline topics among 34 proposed projects; using a multi-criteria analysis approach, we validated a mechanism that followed five stages: determination of the composition of groups, item/domain scoring, weights determination, quality of the information used to support judgments, and finally, topic selection. Participants first scored the importance of each domain, after which four different weighting procedures were calculated (including the survey results. The process of weighting was determined by correlating the data between them. We also reported the quality of evidence used for PDT. Finally, we provided a qualitative analysis of the process. The main domains used to support judgement, having higher quality scores and weightings, were feasibility, disease burden, implementation and information needs. Other important domains such as user preferences, adverse events, potential for health promotion, social effects, and economic impact had lower relevance for clinicians. Criteria for prioritization were mainly judged through professional experience, while good quality information was only used in 15% of cases. Conclusion The main advantages of the proposed methodology are supported by the use of a systematic approach to identify, score and weight guideline topics selection, limiting or exposing the influence of personal biases

  4. The Incidence and Temporal Patterning of Insomnia: a Pilot Study

    Science.gov (United States)

    Perlis, Michael; Phillips, Cindy; Gehrman, Philip R.; Pigeon, Wilfred; Matteson, Sara; Jungquist, Carla

    2014-01-01

    To date very little research has been conducted on night-to-night variability in the incidence of insomnia. Unclear from prior research is whether subjects with Primary Insomnia (PI) exhibit good sleep (or better than average sleep) on some interval basis. In the present study, pilot data are provided on 1) the frequency with which “good sleep” occurs in subjects with PI and 2) whether these events occur in a non-random manner. 10 PI subjects participated in this “naturalistic” study. All subjects completed daily sleep diaries for a minimum of 20 days. None of the subjects received treatment for their insomnia during the monitoring period. The night-tonight data were evaluated by typing each night’s sleep as “Good” or “Bad” and then by determining the number of bad nights that occurred prior to a good night for each subject. Good and bad nights were typed in two ways: 1. using a ≥ 85% cutoff and 2. using a better than the individual’s mean sleep efficiency (idiographic cutoff). Subjects exhibited good sleep on between 29% (> 85% criteria) and 55% (idiographic criteria) of the nights evaluated. The temporal patterning analysis (based on a idiographic cutoff) revealed that better than average sleep most frequently occurred (> 89% of instances) following one to three night’s of poor sleep. These data suggests that insomnia severity may be mediated/moderated by sleep homeostasis and that the homeostat, or input to the homeostat, may be abnormal in patients with Primary Insomnia. PMID:19912510

  5. Accumulation of contaminants from urban rainfall runoff in blue crabs: A pilot study

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The objective of this pilot study was to determine the feasibility of using caged blue crabs Callinectes sapidus to monitor accumulation of contaminants in urban...

  6. Practical Implications of Metacognitively Oriented Psychotherapy in Psychosis : Findings From a Pilot Study

    NARCIS (Netherlands)

    de Jong, Steven; van Donkersgoed, Rozanne J. M.; Aleman, Andre; van der Gaag, Mark; Wunderink, Lex; Arends, Johan; Lysaker, Paul H.; Pijnenborg, Marieke

    2016-01-01

    In preparation for a multicenter randomized controlled trial, a pilot study was conducted investigating the feasibility and acceptance of a shortened version (12 vs. 40 sessions) of an individual metacognitive psychotherapy (Metacognitive Reflection and Insight Therapy [MERIT]). Twelve participants

  7. PILOT STUDY OF TARGETING ELEVATED BLOOD-LEVEL LEVELS IN CHILDREN

    Science.gov (United States)

    THIS PILOT STUDY SEEKS TO DEVELOP STATISTICAL MODELS TO PREDICT RISK OF CHILDHOOD LEAD POISONING WITHIN SPECIFIED GEOGRAPHIC AREAS BASED ON A COMBINATION OF DEMOGRAPHIC, ENVIRONMENTAL, AND PROGRAMMATIC INFORMATION SOURCES.

  8. Breeding Biology of White-faced Ibis in Northwest Nevada Pilot Study Report 1994

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Between June 1 and September 15, 1994, a pilot study was conducted for the purpose of testing and developing techniques necessary in understanding the breeding...

  9. Development of a social skills assessment screening scale for psychiatric rehabilitation settings: A pilot study

    Directory of Open Access Journals (Sweden)

    Poornima Bhola

    2016-01-01

    Full Text Available Context: Deficits in social skills may present in a range of psychiatric disorders, particularly in the more serious and persistent conditions, and have an influence on functioning across various domains. Aims: This pilot study aimed at developing a brief measure, for structured evaluation and screening for social skills deficits, which can be easily integrated into routine clinical practice. Settings and Design: The sample consisted of 380 inpatients and their accompanying caregivers, referred to Psychiatric Rehabilitation Services at a tertiary care government psychiatric hospital. Materials and Methods: The evaluation included an Inpatient intake Proforma and the 20-item Social Skills Assessment Screening Scale (SSASS. Disability was assessed using the Indian Disability Evaluation and Assessment Scale (IDEAS for a subset of 94 inpatients. Statistical Analysis Used: The analysis included means and standard deviations, frequency and percentages, Cronbach's alpha to assess internal consistency, t-tests to assess differences in social skills deficits between select subgroups, and correlation between SSASS and IDEAS scores. Results: The results indicated the profile of social skills deficits assessed among the inpatients with varied psychiatric diagnoses. The “psychosis” group exhibited significantly higher deficits than the “mood disorder” group. Results indicated high internal consistency of the SSASS and adequate criterion validity demonstrated by correlations with select IDEAS domains. Modifications were made to the SSASS following the pilot study. Conclusions: The SSASS has potential value as a measure for screening and individualised intervention plans for social skills training in mental health and rehabilitation settings. The implications for future work on the psychometric properties and clinical applications are discussed.

  10. Visual Outcome of Phacoemulsification versus Small Incision Cataract Surgery in Pseudoexfoliation Syndrome – A Pilot Study

    Science.gov (United States)

    Gadewar, Shveta Bhimashankar

    2017-01-01

    Introduction Available data has highlighted the efficacy of both Phacoemulsification (PHACO) and Small Incision Cataract Surgery (SICS) in the presence of Pseudoexfoliation (PEX) syndrome. In developing countries, both are commonly performed procedures for cataract extraction. But, no direct comparison between these two procedures is available in the setting of PEX syndrome. With this lacuna in mind, this pilot study decided to compare the visual outcomes of both these techniques in the setting of PEX syndrome. Aim To compare and analyze the efficacy and safety of PHACO versus SICS in patients of PEX syndrome who underwent cataract surgery. Materials and Methods A prospective, conveniently sampled, observational, pilot study was conducted over six months in ophthalmology department of a tertiary eye institute in India. A total of 200 eyes of 100 patients conforming to pre-defined criteria were conveniently sampled and allotted to two groups of 50 patients each. First group underwent PHACO and second underwent SICS. The demographic profile, pre-operative, intra-operative and post-operative details and complications as well as visual acuity were recorded. Data obtained was analyzed using chi-square test. Statistical significance was set at 95% Confidence Intervals (CI), i.e., at a p-value of <0.05. Results Of 76 males and 24 females, the mean age was 67.95 years. No statistically significant differences were observed between PHACO and SICS groups with regards to intra-operative complications {overall n=13 in PHACO versus n=21 in SICS, p=0.13}. Controlled sphincterotomy was required in a significantly higher number of SICS cases (p=0.03). No statistically significant differences were observed in terms of post-operative complications (overall n=5 in PHACO versus n=10 in SICS, p=0.26). Conclusion With careful pre-operative assessment, due to intra-operative modifications and surgical expertise, both PHACO and SICS are apparently safe procedures in PEX syndrome.

  11. Appreciative Inquiry: A Pilot Study of School Counselor Graduates

    Science.gov (United States)

    Lewis, Rolla E.; Emil, Serap

    2010-01-01

    Counselor education programs are influenced by humanistic philosophy, including the strengths-based perspective. This article describes how appreciative inquiry, a strengths-based approach to systems change, informed the development of a pilot survey used to assess graduate perceptions of a school counselor education program. (Contains 1 table.)

  12. Pulp response in sound and carious teeth: a pilot study.

    Science.gov (United States)

    Paterson, R C

    1981-02-01

    This article describes a pilot investigation in which the response of the pulps in both sound and carious rat molar teeth to traumatic exposure and treatment with three different compounds was assessed. Two of the compounds appeared to give a more favorable response in carious teeth. These results are discussed, and future experiments described.

  13. Family Planning for Inner-City Adolescent Males: Pilot Study.

    Science.gov (United States)

    Reis, Janet; And Others

    1987-01-01

    Describes a pilot family planning program in an inner-city pediatric practice. Male adolescents were more likely to accept contraceptives if the provider first raised the topic of birth control to them. Identified a desire for anonymity/confidentiality and embarrassment or discomfort as the key reasons for not seeking contraceptives. Emphasizes…

  14. Research Note-Testing for Gerontological Competencies: A Pilot Study

    Science.gov (United States)

    Galambos, Colleen; Curl, Angela L.; Woodbury, Karen

    2014-01-01

    This article reports on the pilot delivery of an evaluation method to gauge student learning of gerontological competencies. Using a pretest and posttest design, data were collected on 46 students over 3 classes. Results indicated significant improvement in how students rated or perceived their competencies skill level between pretest and posttest…

  15. NATO/CCMS PILOT STUDY - CLEAN PRODUCTS AND PROCESSES

    Science.gov (United States)

    The proposed objective of the NATO/CCMS Pilot on clean products and processes is to facilitate further gains in pollution prevention, waste minimization, and design for the environment. It is anticipated that the free exchange of knowledge, experience, data, and models will fost...

  16. Virtual Service, Real Data: Results of a Pilot Study.

    Science.gov (United States)

    Kibbee, Jo; Ward, David; Ma, Wei

    2002-01-01

    Describes a pilot project at the University of Illinois at Urbana-Champaign reference and undergraduate libraries to test the feasibility of offering real-time online reference service via their Web site. Discusses software selection, policies and procedures, promotion and marketing, user interface, training and staffing, data collection, and…

  17. The effect of Reiki on pain and anxiety in women with abdominal hysterectomies: a quasi-experimental pilot study.

    Science.gov (United States)

    Vitale, Anne T; O'Connor, Priscilla C

    2006-01-01

    The purpose of this pilot study was to compare reports of pain and levels of state anxiety in 2 groups of women after abdominal hysterectomy. A quasi-experimental design was used in which the experimental group (n = 10) received traditional nursing care plus three 30-minute sessions of Reiki, while the control group (n = 12) received traditional nursing care. The results indicated that the experimental group reported less pain and requested fewer analgesics than the control group. Also, the experimental group reported less state anxiety than the control group on discharge at 72 hours postoperation. The authors recommend replication of this study with a similar population, such as women who require nonemergency cesarian section deliveries.

  18. Innovations In Diabetes Care Around the World: Case Studies Of Care Transformation Through Accountable Care Reforms.

    Science.gov (United States)

    Thoumi, Andrea; Udayakumar, Krishna; Drobnick, Elizabeth; Taylor, Andrea; McClellan, Mark

    2015-09-01

    The rising prevalence, health burden, and cost of chronic diseases such as diabetes have accelerated global interest in innovative care models that use approaches such as community-based care and information technology to improve or transform disease prevention, diagnosis, and treatment. Although evidence on the effectiveness of innovative care models is emerging, scaling up or extending these models beyond their original setting has been difficult. We developed a framework to highlight policy barriers-institutional, regulatory, and financial-to the diffusion of transformative innovations in diabetes care. The framework builds on accountable care principles that support higher-value care, or better patient-level outcomes at lower cost. We applied this framework to three case studies from the United States, Mexico, and India to describe how innovators and policy leaders have addressed barriers, with a focus on important financing barriers to provider and consumer payment. The lessons have implications for policy reform to promote innovation through new funding approaches, institutional reforms, and performance measures with the goal of addressing the growing burdens of diabetes and other chronic diseases.

  19. A pilot study of palliative medicine fellows' hospice home visits.

    Science.gov (United States)

    Shoemaker, Laura K; Aktas, Aynur; Walsh, Declan; Hullihen, Barbara; Khan, Mohammed I Ahmed; Russell, Kraig M; Davis, Mellar P; Lagman, Ruth; LeGrand, Susan

    2012-12-01

    This was a prospective descriptive study of hospice physician home visits (HVs) conducted by Hospice and Palliative Medicine Fellows. Our objectives were 1) to improve our knowledge of hospice care at home by describing physician HVs 2) to identify the indications for physician HVs and the problems addressed during the HV. Data was collected on 58 consecutive patients using a standardized form completed before and after the home visit. More than half of the persons were women. Most were Caucasian. Median age was 75 years; 57% had cancer; 77% were do-not-resuscitate. 76% HV occurred in the home. The median visit duration was 60 minutes; median travel distance and time 25 miles and 42 minutes, respectively. A hospice nurse case manager was present in 95%. The most common issues addressed during HVs were: health education, symptom management, and psychosocial support. Medication review was prominent. Physicians identified previously unreported issues. Symptom control was usually pain, although 27 symptoms were identified. Medications were important; all home visits included drug review and two thirds drug change. Physicians had unique responsibilities and identified important issues in the HV. Physicians provided both education and symptom management. Physician HVs are an important intervention. HVs were important in continuity of care, however, time-consuming, and incurred considerable travel, and professional time and costs.

  20. Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study

    Directory of Open Access Journals (Sweden)

    Sen Ananda

    2011-06-01

    Full Text Available Abstract Background Regular participation in physical activity can prevent many chronic health conditions. Computerized self-management programs are effective clinical tools to support patient participation in physical activity. This pilot study sought to develop and evaluate an online interface for primary care providers to refer patients to an Internet-mediated walking program called Stepping Up to Health (SUH and to monitor participant progress in the program. Methods In Phase I of the study, we recruited six pairs of physicians and medical assistants from two family practice clinics to assist with the design of a clinical interface. During Phase II, providers used the developed interface to refer patients to a six-week pilot intervention. Provider perspectives were assessed regarding the feasibility of integrating the program into routine care. Assessment tools included quantitative and qualitative data gathered from semi-structured interviews, surveys, and online usage logs. Results In Phase I, 13 providers used SUH and participated in two interviews. Providers emphasized the need for alerts flagging patients who were not doing well and the ability to review participant progress. Additionally, providers asked for summary views of data across all enrolled clinic patients as well as advertising materials for intervention recruitment. In response to this input, an interface was developed containing three pages: 1 a recruitment page, 2 a summary page, and 3 a detailed patient page. In Phase II, providers used the interface to refer 139 patients to SUH and 37 (27% enrolled in the intervention. Providers rarely used the interface to monitor enrolled patients. Barriers to regular use of the intervention included lack of integration with the medical record system, competing priorities, patient disinterest, and physician unease with exercise referrals. Intention-to-treat analyses showed that patients increased walking by an average of 1493 steps

  1. A Pilot Survey of Clergy Regarding Mental Health Care for Children

    Directory of Open Access Journals (Sweden)

    Leigh Blalock

    2012-01-01

    Full Text Available Collaborations between healthcare and faith-based organizations have emerged in the drive to improve access to care. Little research has examined clergy views on collaborations in the provision of mental healthcare, particularly to children. The current paper reports survey responses of 25 clergy from diverse religious traditions concerning mental health care in children. Subjects queried include clergy referral habits, specific knowledge of childhood conditions such as depression and anxiety, past experiences with behavioral health workers, and resources available through their home institutions. Overall, surveyed clergy support collaborations to improve childhood mental health. However, they vary considerably in their confidence with recognizing mental illness in children and perceive significant barriers to collaborating with mental health providers.

  2. Implementing and managing self-management skills training within primary care organisations: a national survey of the expert patients programme within its pilot phase

    Directory of Open Access Journals (Sweden)

    Rogers Anne

    2006-02-01

    Full Text Available Abstract A key element of the United Kingdom (UK health policy reform in relation to chronic disease management is the introduction of a national programme seeking to promote self-care from within the National Health Service (NHS. The mainstay of the Expert Patients Programme (EPP is a six-week training course that provides the opportunity for anyone with a long-term condition to develop new skills to manage their condition better on a day-to-day basis. The course forms part of the NHS self-care support programme, is administered by Primary Care Trusts (PCTs and delivered by people who have personal experience of living with a long-term condition. The NHS' official Expert Patients Programme website presently states that, "Pilot EPP courses began at 26 NHS PCT sites across England in May 2002, and by May 2004 approximately 300 PCTs had either actively implemented pilot courses or had committed to joining. The majority of PCTs are now coming to the end of the pilot phase, with many implementing plans to make EPP sustainable for the long-term." The NHS website heralds the pilot "a success." A national, postal survey of PCT EPP Leads was undertaken in order to examine both the evolvement of EPP during its pilot stage and future plans for the programme. A questionnaire was sent out to the 299 PCTs known to have committed to the EPP pilot, and an excellent 100% response rate was obtained over a 3-month period (April-July 2005. One marker of success of the Expert Patients Programme implementation is the actual running of courses by the Primary Care Trusts. This paper explores the extent to which the implementation of the pilot can indeed be viewed as a "success," primarily in terms of the number of courses run, and considers the extent to which PCTs have carried out all that they were committed to do. Findings suggest that the more time an EPP Lead dedicates to the Programme, the more likely it is that EPP has run successfully in the past, and the more

  3. Coal resources available for development; a methodology and pilot study

    Science.gov (United States)

    Eggleston, Jane R.; Carter, M. Devereux; Cobb, James C.

    1990-01-01

    Coal accounts for a major portion of our Nation's energy supply in projections for the future. A demonstrated reserve base of more than 475 billion short tons, as the Department of Energy currently estimates, indicates that, on the basis of today's rate of consumption, the United States has enough coal to meet projected energy needs for almost 200 years. However, the traditional procedures used for estimating the demonstrated reserve base do not account for many environmental and technological restrictions placed on coal mining. A new methodology has been developed to determine the quantity of coal that might actually be available for mining under current and foreseeable conditions. This methodology is unique in its approach, because it applies restrictions to the coal resource before it is mined. Previous methodologies incorporated restrictions into the recovery factor (a percentage), which was then globally applied to the reserve (minable coal) tonnage to derive a recoverable coal tonnage. None of the previous methodologies define the restrictions and their area and amount of impact specifically. Because these restrictions and their impacts are defined in this new methodology, it is possible to achieve more accurate and specific assessments of available resources. This methodology has been tested in a cooperative project between the U.S. Geological Survey and the Kentucky Geological Survey on the Matewan 7.5-minute quadrangle in eastern Kentucky. Pertinent geologic, mining, land-use, and technological data were collected, assimilated, and plotted. The National Coal Resources Data System was used as the repository for data, and its geographic information system software was applied to these data to eliminate restricted coal and quantify that which is available for mining. This methodology does not consider recovery factors or the economic factors that would be considered by a company before mining. Results of the pilot study indicate that, of the estimated

  4. Cardiometabolic Risk among African-American Women: A Pilot Study

    Science.gov (United States)

    Appel, Susan J.; Oster, Robert A.; Floyd, Natalie A.; Ovalle, Fernando

    2010-01-01

    Objective To determine the associations of the Homeostatic Model of Assessment-insulin resistance (HOMA-ir), acanthosis nigricans, high sensitivity C-reactive protein (hs-CRP), and plasminogen activator inhibitor-1 (PAI-1) with two of the commonly used definitions of the metabolic syndrome (Adult Treatment Panel III {ATP III} and International Diabetes Federation {IDF}) among reproductive age healthy free living African-American women. Methods A pilot study with a cross-sectional design examined 33 African-American women aged 20 to 46 (mean 31.24, +/- 7.25), for the presence of metabolic syndrome determined by ATP III and IDF criteria, insulin resistance (HOMA-ir and/or acanthosis nigricans), degree of inflammation (hs-CRP) and presence of dysfibrinolysis (PAI-1). Results HOMA-ir identified insulin resistance in 27 (81.8%) of the women, whereas the presence of acanthosis nigricans indicated that 16 (48 %) of these women manifested insulin resistance. Metabolic syndrome was found in 7 women (21.2 %) by ATP III or 9 (27.3 %) by IDF criteria. Bivariate correlations showed associations between HOMA-ir and waist circumference, body mass index (BMI), acanthosis nigricans, the ATP III and IDF definitions for metabolic syndrome. PAI-1 was significantly correlated with waist circumference, BMI, fasting glucose, HOMA-ir, and ATP III. Both HOMA-ir and PAI-1 were significantly and negatively correlated with HDL-C. hs-CRP was significantly correlated with BMI and 2-hour post glucose. Conclusion Both dysfibrinolysis (PAI-1 levels) and insulin resistance (HOMA-ir) when individually regressed on the ATP III definition of metabolic syndrome explained 32 % and 29% of the respective variance. The addition of HOMA-ir measurement may significantly improve early recognition of cardiometabolic risk among reproductive age African-American women who have not yet met the criteria for the ATP III or IDF definitions of the metabolic syndrome. Likewise, acanthosis nigricans is potentially a

  5. The success of the Washington Department of Labor and Industries Managed Care Pilot Project: the occupational medicine-based delivery model.

    Science.gov (United States)

    Sparks, P J; Feldstein, A

    1997-11-01

    The Washington State Managed Care Pilot Project (MCP) tested the effects of experience-rated capitation on medical and disability costs, quality of care, worker satisfaction with medical care, and employer satisfaction in MCP-covered workers, compared with matched fee-for-service controls. In the MCP, medical costs were reduced by approximately 27%, functional outcomes remained the same, workers were less satisfied with their treatment and access to care initially, and employers were-much more satisfied with the quality and speed of the information received from the providers. The authors believe that it was the occupational medicine-based delivery model, working in conjunction with the method of reimbursement and the cultural context of managed care, that was the most significant innovation leading to the MCP successes. This article describes the occupational medicine-based delivery model implemented for the MCP.

  6. The Dental Needs of Army Family Members, 1986: Pilot Study

    Science.gov (United States)

    1990-05-10

    pediatric dentistry programs as well as larger families appear to value access to free dental care. Since the DoD had not announced details of its dental insu...Category of Care and by Age Group: --For Children (age 4-14): Diagnostic & Preventive $27-$80 Restorations, stainless steel crowns , and extractions (Basic... crowns , and extractions. Comprehensive services consist of basic care, space maintenance, and orthodon- tics. For youths and adults, average costs were

  7. Negative pressure and nanocrystalline silver dressings for nonhealing ulcer: A randomized pilot study.

    Science.gov (United States)

    Sáez-Martín, Luis C; García-Martínez, Lourdes; Román-Curto, Concepción; Sánchez-Hernández, Miguel V; Suárez-Fernández, Ricardo M

    2015-01-01

    Chronic wounds have a high prevalence and wound care, treatment, and prevention consume large quantities of resources. Chronic wounds are a growing challenge for clinicians. A prospective randomized pilot study was conducted to assess the effectiveness in terms of reduction in area and safety of the combined use of negative-pressure wound therapy and nanocrystalline silver dressings as compared to negative pressure wound therapy (NPWT) alone in the management of outpatients with chronic wounds. A total of 17 patients were included in the study, 10 were treated with the combined method and 7 with NPWT. Patients were followed for 6 weeks, with a final assessment at 3 months. Clinical improvement, microbiologic data, and toxicity of silver were evaluated. The antibacterial effects of ionic silver together with the development of granulation tissue promoted by NPWT reduced significantly the median extension of the wound between weeks 3 and 6 of treatment. The combination with silver also reduced bacterial colonization with Pseudomonas aeruginosa and the bacterial load on the surface of the wound. The silver levels correlated positively with the extension of the wound, although in none of the patients' toxic levels were reached. The combination of NPWT with nanocrystalline silver dressings was safe and as effective as NPWT alone.

  8. Embedding evidence-based practice among nursing undergraduates: Results from a pilot study.

    Science.gov (United States)

    André, Beate; Aune, Anne G; Brænd, Jorunn A

    2016-05-01

    Evidence-based practice is currently one of the most important developments in health care. Research in nursing science is rapidly growing; however, translating the knowledge based on this research into clinical practice is often hampered, and may be dependent on reflective skills. The aim of this study was to see how undergraduate nursing students in nursing should increase their skills and knowledge related to evidence-based practice through participation in clinical research projects. A qualitative approach was used in collecting and analyzing the data. Students participated in a pilot clinical research project and a received guidance related to their bachelor thesis. After the project was completed, all students filled in a questionnaire. The students' motivation to participate in this study was reported to be high, but they reported low knowledge related to evidence-based practice. All students reported that their attitude towards evidence-based practice changed in a positive direction during their participation in the project. Evidence-based practice influenced nursing practices by putting more focus on critical thinking, increasing pride and giving a sense of ownership in the clinical field. The curricula and the pedagogical perspectives in nursing education can influence the attitude towards evidence-based practice and skills among nursing bachelor students.

  9. Advancing safe drug use through interprofessional learning (IPL): a pilot study.

    Science.gov (United States)

    Achike, Francis I; Smith, John; Leonard, Stuart; Williams, Janet; Browning, Felicia; Glisson, James

    2014-07-01

    Interprofessional collaborative patient-centered care (IPCPC) improves healthcare quality and cost. Drug-related morbidity drives healthcare costs, thus requiring IPCPC approaches. The lack of educational preparedness for would-be IPCPC practitioners underlies the failure of historic IPCPC attempts, hence today's emphasis on pre-licensure interprofessional education (IPE). A pilot IPE class was conducted on rational drug use (RDU) through rational drug prescribing. Twenty fourth-year nursing students and 88 second-year medical students participated (8-10 medical per 2-3 nursing students) in small group activity in a lecture hall. A case study on rational drug choice and prescription writing processes from medical and nursing perspectives was used. Eighty of 108 (74%) students completed the post-activity questionnaire and were satisfied with the class, with a mean weighted score (mws) of 0.8. The learning outcomes (mws = 1.0) contributed more (P classroom were, respectively, the most- and least-liked aspects of the class. The study revealed students' appetite for IPE, highlights the challenges in developing IPE curricula, and could serve as impetus for schools developing IPE for RDU curricula.

  10. The use of a surgical incision management system on vascular surgery incisions: a pilot study.

    Science.gov (United States)

    Weir, Gregory

    2014-06-01

    Health care-associated infections in hospitals, including surgical site infections, contribute significantly to morbidity as well as mortality. Surgical incision management (SIM) using negative pressure wound therapy (Prevena™ Incision Management System, Kinetic Concepts, Inc., San Antonio, TX, USA) is designed to cover and protect closed surgical incisions from external factors including infectious sources and local trauma, while negative pressure removes fluid and infectious material from the surgical incision. A prospective case-control study assessed wound complications in patients undergoing vascular bypass procedures, where both femoral areas were incised to gain access to the femoral arteries. SIM was placed on one femoral area while a standard postoperative wound dressing was placed on the contralateral femoral area. Eight patients were included in this pilot study. All of them required bilateral femoral artery access. During the follow-up period patients were monitored for wound complications. All wound complications requiring surgical intervention were considered significant. No significant wound complications occurred in wounds treated with SIM, compared with three significant complications in control wounds. These preliminary data would suggest a potential reduction in wound complications and no observed increase in haemorrhage in high-risk patients with severe co-morbidities undergoing vascular surgery.

  11. Designing the care environment in hospitals and nursing homes: a pilot for a new and reliable method for determining the optimum space to live in and work in.

    Science.gov (United States)

    Knibbe, J J; Waaijer, E

    2012-01-01

    One of the major problems encountered in health care during the process of implementing ergonomic changes is the lack of space. There is often not enough space to work with larger equipment like patient lifters and shower chairs or other medical devices necessary in a preventive program. This leads to undesirable extra physical load for nurses. Therefore it is imperative that in the process of designing the health care environment ergonomic considerations are taken into account. A method to assess the optimum size and shape of the space required is developed and the value of the method is tested in a pilot setting. The pilot is currently underway and the results will be presented on the final poster.

  12. [Semiotic Studies Lab for Patient Care Interactions].

    Science.gov (United States)

    Nunes, Dulce Maria; Portella, Jean Cristtus; Bianchi e Silva, Laura

    2011-12-01

    The aim of this experience report is to present the Semiotic Studies Lab for Patient Care Interactions (Laboratório de Estudos Semióticos nas Interações de Cuidado - LESIC). The lab was set up at the Nursing School of the Federal University of Rio Grande do Sul (UFRGS), Brazil in 2010. It has the purpose of providing didactic and pedagogical updates, based on the Theory developed by the Paris School of Semiotics, that enable the increase of knowledge and interactive/observational skills regarding the nature and mastery of human care.

  13. Comparison of three peripherally-inserted central catheters: pilot study.

    Science.gov (United States)

    Di Giacomo, Michele

    Peripherally-inserted central catheters (PICCS) are non-tunnelled, central catheters inserted through a peripheral vein of the arm. They are 50-60 cm long and are usually made of either silicone or second-third generation polyurethane. PICCs can be used for prolonged, continuous or intermittent infusion therapies (up to 3 months) both in hospitalized patients and in patients treated as outpatients, in a hospice, or at home. When establishing a vascular service it is key to select a PICC that meets the requirements of safety, cost-effectiveness, high resistance (ability to take increasing fluid volumes with high pressure devices) and durability, and low complications rate. The complications and dwell times of three different PICCs were studied: coated polyurethane, valved silicone and power-injectable. The study was conducted at the chemotherapy suite at the author's hospital with the aim of selecting the right PICC based on low incidence of complications, resistance and enhanced dwell time. Results show a low incidence of complications and long dwell time among patients with the power-injectable PICC. Furthermore, this study demonstrated a reduction on the rate of occlusion and rupture with power-injectable PICCs, which makes them safer to use for administration of chemotherapy and other vesicant agents, as well as for the management of patients in critical care.

  14. Multidisciplinary group performance – measuring integration intensity in the context of the North West London Integrated Care Pilot

    Directory of Open Access Journals (Sweden)

    Matthew Harris

    2013-02-01

    Full Text Available Introduction: Multidisciplinary Group meeting (MDGs are seen as key facilitators of integration, moving from individual to multi-disciplinary decision making, and from a focus on individual patients to a focus on patient groups.  We have developed a method for coding MDG transcripts to identify whether they are or are not vehicles for delivering the anticipated efficiency improvements across various providers and apply it to a test case in the North West London Integrated Care Pilot.  Methods:  We defined 'integrating' as the process within the MDG meeting that enables or promotes an improved collaboration, improved understanding, and improved awareness of self and others within the local healthcare economy such that efficiency improvements could be identified and action taken.  Utterances within the MDGs are coded according to three distinct domains grounded in concepts from communication, group decision-making, and integrated care literatures - the Valence, the Focus, and the Level.  Standardized weighted integrative intensity scores are calculated across ten time deciles in the Case Discussion providing a graphical representation of its integrative intensity. Results: Intra- and Inter-rater reliability of the coding scheme was very good as measured by the Prevalence and Bias-adjusted Kappa Score.  Standardized Weighted Integrative Intensity graph mirrored closely the verbatim transcript and is a convenient representation of complex communication dynamics. Trend in integrative intensity can be calculated and the characteristics of the MDG can be pragmatically described. Conclusion: This is a novel and potentially useful method for researchers, managers and practitioners to better understand MDG dynamics and to identify whether participants are integrating.  The degree to which participants use MDG meetings to develop an integrated way of working is likely to require management, leadership and shared values.

  15. Multidisciplinary group performance – measuring integration intensity in the context of the North West London Integrated Care Pilot

    Directory of Open Access Journals (Sweden)

    Matthew Harris

    2013-02-01

    Full Text Available Introduction: Multidisciplinary Group meeting (MDGs are seen as key facilitators of integration, moving from individual to multi-disciplinary decision making, and from a focus on individual patients to a focus on patient groups.  We have developed a method for coding MDG transcripts to identify whether they are or are not vehicles for delivering the anticipated efficiency improvements across various providers and apply it to a test case in the North West London Integrated Care Pilot. Methods:  We defined 'integrating' as the process within the MDG meeting that enables or promotes an improved collaboration, improved understanding, and improved awareness of self and others within the local healthcare economy such that efficiency improvements could be identified and action taken.  Utterances within the MDGs are coded according to three distinct domains grounded in concepts from communication, group decision-making, and integrated care literatures - the Valence, the Focus, and the Level.  Standardized weighted integrative intensity scores are calculated across ten time deciles in the Case Discussion providing a graphical representation of its integrative intensity.Results: Intra- and Inter-rater reliability of the coding scheme was very good as measured by the Prevalence and Bias-adjusted Kappa Score.  Standardized Weighted Integrative Intensity graph mirrored closely the verbatim transcript and is a convenient representation of complex communication dynamics. Trend in integrative intensity can be calculated and the characteristics of the MDG can be pragmatically described.Conclusion: This is a novel and potentially useful method for researchers, managers and practitioners to better understand MDG dynamics and to identify whether participants are integrating.  The degree to which participants use MDG meetings to develop an integrated way of working is likely to require management, leadership and shared values.

  16. Development of training-related health care software by a team of clinical educators: their experience, from conception to piloting

    Directory of Open Access Journals (Sweden)

    ap Dafydd D

    2016-11-01

    Full Text Available Derfel ap Dafydd,1 Ruth Williamson,2 Philip Blunt,3 Dominic M Blunt4 1Department of Radiology, Royal Marsden NHS Foundation Trust, London, 2Imaging Department, Royal Bornemouth Hospital, Bornemouth, 3Savernake IT Ltd, Marlborough, 4Imaging Department, Imperial College Healthcare NHS Trust, London, UK Abstract: The difficulties of producing useful, bespoke, and affordable information technology systems for large health care organizations are well publicized, following several high-profile endeavors in the UK. This article describes the experience of a small group of clinical radiologists and their collaborators in producing an information technology system – from conception to piloting. This system, called Trainee Tracker, enables automated target date recalculation of trainee milestones, depending on their work patterns and other individual circumstances. It utilizes an automated email alert system to notify the educational supervisors and trainees of approaching and elapsed target dates, in order to identify trainees in difficulty early and address their training needs accordingly. The challenges and advantages, both common to and contrasting with larger-scale projects, are also considered. The benefits of the development team’s “agile” approach to software development and the lessons learned will be of interest to medical educators, particularly those with expertise in e-portfolios and other training-related software. Keywords: training, appraisal, ARCP, Annual Review of Clinical Progression, portfolio, trainer

  17. Evaluation of the qualitative and quantitative characteristics of dual diagnosis (Pilot Study

    Directory of Open Access Journals (Sweden)

    Maria Prodromou

    2015-03-01

    included e.g. the educational background, their occupation, their police record, their family and interpersonal relationships. Conclusion: Despite the fact that the minority of the patients admitted in (RTRP have double diagnosis, this study reports that patients with dual diagnosis live treatment earlier than patients with drug addiction only. Dual diagnosis negatively affect prognosis in patients with drug dependence. Concluding this pilot study is supporting those clients that are diagnosed with co morbid disorder should be assessed and evaluated at the beginning of their treatment in order to offer them care that is meeting their needs and encourage them to adhere with their treatment

  18. The association of patients' oral health literacy and dental school communication tools: a pilot study.

    Science.gov (United States)

    Tam, Amy; Yue, Olivia; Atchison, Kathryn A; Richards, Jessica K; Holtzman, Jennifer S

    2015-05-01

    The aim of this pilot study was to assess adult patients' ability to read and understand two communication tools at the University of California, Los Angeles, School of Dentistry: the dental school clinic website and a patient education brochure pertaining to sedation in children that was written by dental school personnel. A convenience sample of 100 adults seeking treatment at the school's general dental clinic during 2012-13 completed a health literacy screening instrument. They were then asked to read clinic educational and informational materials and complete a survey. Analyses were conducted to determine the association between the subjects' oral health literacy and sociodemographics and their ability to locate and interpret information in written oral health information materials. SMOG and Flesch-Kincade formulas were used to assess the readability level of the electronic and written communication tools. The results demonstrated an association between these adults' oral health literacy and their dental knowledge and ability to navigate health information website resources and understand health education materials. Health literacy was not associated with age or gender, but was associated with education and race/ethnicity. The SMOG Readability Index determined that the website and the sedation form were written at a ninth grade reading level. These results suggest that dental schools and other health care organizations should incorporate a health-literate approach for their digital and written materials to enhance patients' ability to navigate and understand health information, regardless of their health literacy.

  19. Histological Diagnosis of Oral Lesions with Cutting Needle Biopsy: a Pilot Study

    Directory of Open Access Journals (Sweden)

    José Antonio Rossi dos Santos

    2011-04-01

    Full Text Available Objectives: The aim of this pilot study was to evaluate the effectiveness of cutting needle biopsy in the diagnosis of solid oral lesions.Material and Methods: The biopsies were carried out on seven patients who presented with solid oral lesions with sizes ranging from 2 to 6 cm. Specimens were obtained from each lesion before conventional biopsies using a cutting needle with 18-gauge x 9 cm (MD TECH, Gainesville, FL, USA. A total of 64 specimens processed by hematoxylin-eosin staining method, were obtained. Afterwards, the analysis was performed by an oral pathologist, in two different stages, with and without the clinical history of each lesion. Then, these answers were compared with the final histological diagnosis.Results: Results presented by the descriptive analysis showed that the correct diagnosis using cutting needle biopsy without the clinical history of lesions was registered in 37.5% of cases, while with the clinical history in 76.6%.Conclusions: Despite the promising results as a potential technique for biopsies and histological diagnosis of oral lesions, the cutting needle biopsy should be analyzed carefully in those cases.

  20. Pilot Study on Carbon-sand Filter for Sedimentation Effluent

    Directory of Open Access Journals (Sweden)

    Zhang Shuo

    2015-01-01

    Full Text Available The development of dual function of integrating with activated carbon adsorption and quartz sand filtration in the carbon-sand filter can collaboratively remove organic matters and turbidity and also protect the bio-security, and the pilot test is carried out to optimize the process parameters. The pilot test results show that the thickness of the filter materials is preferably 1,300mm of the activated carbon, 500mm of uniform quartz sand; filtration rate can be 8-12m/h; filter cycle is 24-48h; when the water temperature is 21°C to 29°C, the biofilm formation period in the carbon-sand filter is 15 to 20 days; removal of the organic matters and nitrogen runs through the entire filter bed, and the nitrite is mainly oxidized on the upper side; when the operation is mature, the layer of filter materials can form the biofilm and zoogloea, with the dual function of micro-biological degradation and activated carbon adsorption.

  1. Improving clinician confidence and skills: piloting a web-based learning program for clinicians in supportive care screening of cancer patients.

    Science.gov (United States)

    Beattie, Jill; Brady, Lisa; Tobias, Tracey

    2014-03-01

    Lean thinking and quality improvement processes identified a need to develop and implement a short concise web-based program for clinicians to increase their confidence and skills in supportive care screening of cancer patients. An independent pretest-posttest design evaluated the program which consisted of three modules, a self-directed learning quiz, and multimedia. Questionnaires were completed anonymously via SurveyMonkey®. There was an increase in mean scores from pre- to post-program in perceived knowledge (pre M = 1.97 SD = .847; post M = 3.05 SD = .486; 3 months M = 2.72 SD = .575), educational preparedness (pre M = 2.33 SD = .957; post M = 3.45 SD = .510; 3 months M = 3.05 SD = .486), and confidence (pre M = 2.39 SD = .998; post M = 3.32 SD = .646; 3 months M = 3.28 SD = .826), indicating improvement in readiness to implement supportive care screening. The number of participants using the tool increased from 57.57% pre-program to 77.78% 3 months post-program. Overall, participants agreed that screening elicited more patient information (post M = 3.82 SD = 1.006; 3 months M = 3.83 SD = .786) and would assist in addressing patients' supportive care needs (post M = 4.00 SD.926; 3 months M = 3.94 SD = .998). It was unclear whether they had made more appropriate referrals as a result of their participation in the program (post M = 3.29 SD = 1.102; 3 months M = 3.11 SD = .963). The majority of participants agreed that the web-based program provided the required information to implement supportive care screening (post M = 3.83 SD = 1.032; 3 months M = 3.61 SD = .702), and that the quiz helped their learning (post M = 3.68 SD = 1.041; 3 months M = 3.65 SD = .702). This pilot indicates that provision of a short concise web-based program may improve clinicians' confidence and skills to implement supportive care

  2. Pilot Study of Flow and Meaningfulness as Psychological Learning Concepts in Patient Education: A Short Report

    DEFF Research Database (Denmark)

    Nicic, Sara; Nørby, Karina; Bruun Johansen, Clea

    2014-01-01

    Abstract Background: The aim of this pilot study was to explore patient experiences of meaningfulness and flow related to group based patient education in type 2 diabetes. Meaningfulness and flow are underexposed as psychological learning concepts in patient education, and the ambition of this st......Abstract Background: The aim of this pilot study was to explore patient experiences of meaningfulness and flow related to group based patient education in type 2 diabetes. Meaningfulness and flow are underexposed as psychological learning concepts in patient education, and the ambition...... of this study was to investigate the applicability of these concepts of positive psychological theory in a patient education setting. Methods: This pilot study combines participating observation of group based patient education and 8 qualitative interviews with 4 patients with type 2 diabetes. Meaning...... in the patient education setting. Patients experienced that there was a clear, comprehensive and structured plan for the education programme which was followed. This stimulated their experiences of meaningfulness and flow....

  3. 360 Derece Performans Değerlendirme ve Geri Bildirim: Bir Üniversite Mediko-Sosyal Merkezi Birim Amirlerinin Yönetsel Yetkinliklerinin Değerlendirilmesi Üzerine Pilot Uygulama Örneği(360 Degree Performance Appraisal And Feedback: “A Pilot Study Illustration in Appraising the Managerial Skills of Supervisors Working in Health Care Centre of a University”

    Directory of Open Access Journals (Sweden)

    Selin Metin CAMGÖZ

    2006-01-01

    Full Text Available In this study, “360 Degree Performance Appraisal” which is one of the most current and controversial issues of human resource practices is extensively examined and supported with an empirical research. The study contains 2 parts. After explaining the necessity and the general utilities of the classical performance appraisal system, the first theoretical part shifts to the emergence of 360 degree performance appraisal, discusses its distinctive benefits over the classical appraisal system and focuses its attention to the raters (superiors, subordinates, peers, self involving in the 360 degree performance appraisal.The second empirical part illustrates the development of 360 degree performance appraisal system as well as its application and sample feedback reports for feedback purposes in order to appraise the managerial skills of supervisors working in Health Care Centre of a public university.

  4. A virtual classroom for undergraduate periodontology: a pilot study.

    Science.gov (United States)

    Mattheos, N; Nattestad, A; Schittek, M; Attström, R

    2001-11-01

    The Integrated Distributed Learning Environments or virtual classrooms constitute a new promising structure in education of health care personnel. A virtual classroom was developed aiming to teach periodontology to an international group of 28 dental students using a problem-based learning (PBL) approach. The course was web-based and included synchronous and asynchronous communication, on-line libraries and multimedia material. Students were organised in 4 independent groups and each group was appointed a tutor. The results of the study indicate that one of the most positive effects students experienced was competence in using the computer. They also rated highly the use of multimedia for learning of clinical procedures. It was found that web boards and email were too slow to allow group work in the virtual classroom. Real time communication programs were found to be superior for problem discussion and hypothesis formulation. However, email and the web board played a significant role during certain steps of the PBL method. The students expressed a positive attitude for the combined use of network-based learning and problem-based education. Our present experience suggests that distance learning should be organised with a mixture of different media, allowing communication of knowledge and skills between the resources and the students, as well as cooperation between the students. Computer literacy among teachers and students is limited and should be enhanced. Finally, personal contact between the resource persons and the students before the distant learning course commences helps the learning process.

  5. Caring Teaching as a Moral Practice: An Exploratory Study on Perceived Dimensions of Caring Teaching

    Directory of Open Access Journals (Sweden)

    Khalil Gholami

    2012-01-01

    Full Text Available Caring teaching is a conceptual framework used to gain an insight into the moral aspect of teaching. Using a quantitative research approach, we studied 556 teachers in order to explore their perceived dimensions of caring teaching. Drawing on existing literature, we found that caring teaching has been elaborated in line with two broad concepts: personal care and academic care. Considering these concepts, we developed the Caring Teaching Scale with which we identified four dimensions of caring teaching: the nurturing of a student's character, didactical bias, awareness, and respectful didactics. A meta-analysis reflection suggests that the nurturing of students' characters and awareness represent personal care while didactical bias and respectful didactics call for academic care. Further analysis showed that these teachers attached more pedagogical value to personal care. Controlling for two demographic variables, we found statistically significant differences with regard to gender and caring teaching.

  6. Pilot Study of Flow and Meaningfulness as Psychological Learning Concepts in Patient Education: A Short Report

    DEFF Research Database (Denmark)

    Nicic, Sara; Nørby, Karina; Bruun Johansen, Clea;

    2014-01-01

    Abstract Background: The aim of this pilot study was to explore patient experiences of meaningfulness and flow related to group based patient education in type 2 diabetes. Meaningfulness and flow are underexposed as psychological learning concepts in patient education, and the ambition...... of this study was to investigate the applicability of these concepts of positive psychological theory in a patient education setting. Methods: This pilot study combines participating observation of group based patient education and 8 qualitative interviews with 4 patients with type 2 diabetes. Meaning...

  7. Children with Autism and Attention Difficulties: A Pilot Study of the Association between Sensory, Motor, and Adaptive Behaviors

    Science.gov (United States)

    Mattard-Labrecque, Carolanne; Ben Amor, Leila; Couture, Mélanie M.

    2013-01-01

    Objectives: This pilot study aimed to compare sensory processing, motor skills and adaptive behaviors in children with a double diagnosis of Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) (ASD+ADHD) with children with ADHD alone and to examine the association of sensory processing and motor skills with adaptive behaviors (self-care). Method: Thirty children aged 5–14 years diagnosed with ASD+ADHD (n = 13) or ADHD (n = 17) were evaluated on their sensory processing and motor skills and adaptive behaviors. Analysis of covariance compared the groups on these dimensions. Correlation analyses examined the association between sensory processing and motor skills and adaptive behaviors. Results: Compared to children with ADHD alone, children with ASD+ADHD had poorer skills in sensory processing (p < 0.001), motor (p = 0.001) and adaptive behaviors (p < 0.001). For all children, increased autonomy in self-care was correlated with better sensory processing (p < 0.001) and motor skills (p = 0.002). Conclusion: Children with ASD+ADHD have poorer sensory processing, motor and adaptive skills than those with ADHD alone. Sensory processing and motor deficits were negatively associated with autonomy in self-care. Interventions aiming to improve sensory processing and motor skills and autonomy in self-care should become important targets for these children. PMID:23667360

  8. A pilot study of complementary and alternative medicine use in patients with fibromyalgia syndrome

    Directory of Open Access Journals (Sweden)

    Wall GC

    2007-12-01

    Full Text Available Fibromyalgia syndrome (FMS is a complex disorder, with primary symptoms of sleep disturbances, pain, and fatigue. FMS is one of the most common reasons for patient visits to a rheumatologist. Previous studies have suggested that complementary and alternative medicine (CAM use in patients with rheumatic diseases is common, but such data specific to FMS patients is limited. Objective: The following study sought to describe the prevalence of CAM use in a primary care practice of patients with FMS and assess whether these patients discuss CAM use with their physician, physician-extender, and/or pharmacist. Methods: A one-group cross-sectional survey design was implemented in a large, community-based, private physician practice of patients diagnosed with FMS. A self-administered questionnaire was distributed during clinic visits. It solicited information related to demographic characteristics; FMS-specific health background; whether CAM use had been discussed with a health care provider; and the “ever-use” of common types of CAM. Respondents returned the questionnaire via US mail in a postage-paid, self-addressed envelope. Results: A total of 115 surveys were distributed with 54 returned for analysis (47% completion rate. The sample was predominantly female, well educated and had a mean age of 55.6 years. All respondents were White. Most respondents (92.6% reported using some type of CAM. Exercise (92.2%, chiropractic treatment (48.1%, lifestyle and diet (45.8%, relaxation therapy (44.9%, and dietary and herbal supplements (36.5% were most commonly reported CAM therapies “ever-used” by respondents. Dietary and herbal supplements with the highest prevalence of “ever-use” were magnesium (19.2%, guaifenesin (11.5%, and methylsulfonylmethane (MSM (9.6%. Respondents most commonly discussed CAM with the clinic rheumatologist and the primary care physician (53.7% and 38.9%, respectively. Only 14.8% of respondents discussed CAM with a pharmacist

  9. Treatment of a colored groundwater by ozone-biofiltration: pilot studies and modeling interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Rittmann, B.E.; Stilwell, D.; Garside, J.C.; Amy, G.L.; Spangenberg, C.; Kalinsky, A.; Akiyoshi, E. [Northwestern University, Evanston, IL (USA). Dept. of Civil & Environmental Engineers

    2002-07-01

    Pilot studies investigated the fates of color, dissolved organic carbon (DOC), and biodegradable organic matter (BOM) by the tandem of ozone plus biofiltration for treating a source water having significant color (50 cu) and DOC (3.2 mg/l). Transferred ozone doses were from 1.0 to 1.8 g O{sub 3}/g C. Rapid biofilters used sand, anthracite, or granular activated carbon as media with empty-bed contact time (EBCT) up to 9 min. The pilot studies demonstrated that ozonation plus biofiltration removed most color and substantial DOC, and increasing the transferred ozone dose enhanced the removals. Compared to sand and anthracite biofilters, the GAC biofilter gave the best performance for color and DOC removal, but some of this enhanced performance was caused by adsorption, since the GAC was virgin at the beginning of the pilot studies.

  10. Maintenance Model of Integrated Psychosocial Treatment in Pediatric Bipolar Disorder: A Pilot Feasibility Study

    Science.gov (United States)

    West, Amy E.; Henry, David B.; Pavuluri, Mani N.

    2007-01-01

    Objective: The chronic and refractory course of pediatric bipolar disorder merits the study of adjunctive psychosocial interventions designed to facilitate long-term improvements. The objective of this study is to conduct a pilot study of a maintenance model of the child- and family-focused cognitive-behavioral therapy program (CFF-CBT), which…

  11. Family-Centered Care in Juvenile Justice Institutions: A Mixed Methods Study Protocol

    Science.gov (United States)

    Mulder, Eva; Rigter, Henk; Breuk, René; van der Vaart, Wander; Vermeiren, Robert

    2016-01-01

    Background Treatment and rehabilitation interventions in juvenile justice institutions aim to prevent criminal reoffending by adolescents and to enhance their prospects of successful social reintegration. There is evidence that these goals are best achieved when the institution adopts a family-centered approach, involving the parents of the adolescents. The Academic Workplace Forensic Care for Youth has developed two programs for family-centered care for youth detained in groups for short-term and long-term stay, respectively. Objective The overall aim of our study is to evaluate the family-centered care program in the first two years after the first steps of its implementation in short-term stay groups of two juvenile justice institutions in the Netherlands. The current paper discusses our study design. Methods Based on a quantitative pilot study, we opted for a study with an explanatory sequential mixed methods design. This pilot is considered the first stage of our study. The second stage of our study includes concurrent quantitative and qualitative approaches. The quantitative part of our study is a pre-post quasi-experimental comparison of family-centered care with usual care in short-term stay groups. The qualitative part of our study involves in-depth interviews with adolescents, parents, and group workers to elaborate on the preceding quantitative pilot study and to help interpret the outcomes of the quasi-experimental quantitative part of the study. Results We believe that our study will result in the following findings. In the quantitative comparison of usual care with family-centered care, we assume that in the latter group, parents will be more involved with their child and with the institution, and that parents and adolescents will be more motivated to take part in therapy. In addition, we expect family-centered care to improve family interactions, to decrease parenting stress, and to reduce problem behavior among the adolescents. Finally, we assume

  12. A pilot study to evaluate runoff quantity from green roofs.

    Science.gov (United States)

    Lee, Ju Young; Lee, Min Jung; Han, Mooyoung

    2015-04-01

    The use of green roofs is gaining increased recognition in many countries as a solution that can be used to improve environmental quality and reduce runoff quantity. To achieve these goals, pilot-scale green roof assemblies have been constructed and operated in an urban setting. From a stormwater management perspective, green roofs are 42.8-60.8% effective in reducing runoff for 200 mm soil depth and 13.8-34.4% effective in reducing runoff for 150 mm soil depth. By using Spearman rank correlation analysis, high rainfall intensity was shown to have a negative relationship with delayed occurrence time, demonstrating that the soil media in green roofs do not efficiently retain rainwater. Increasing the number of antecedent dry days can help to improve water retention capacity and delay occurrence time. From the viewpoint of runoff water quality, green roofs are regarded as the best management practice by filtration and adsorption through growth media (soil).

  13. Activation of Coagulation and Fibrinolysis in Acute Respiratory Distress Syndrome: a Prospective Pilot Study

    Directory of Open Access Journals (Sweden)

    Agnese Ozolina

    2016-11-01

    Full Text Available Introduction: Coagulation and fibrinolysis remain sparsely addressed with regards to acute respiratory distress syndrome (ARDS. We hypothesized that ARDS development might be associated with changes in plasma coagulation and fibrinolysis. Our aim was to investigate the relationships between ARDS diagnosis and plasma concentrations of tissue factor (TF, tissue plasminogen activator (t-PA and plasminogen activator inhibitor-1 (PAI-1 in mechanically ventilated patients at increased risk of developing ARDS. Materials and Methods: We performed an ethically approved prospective observational pilot study. Inclusion criteria: patients with PaO2/FiO2 < 300 mmHg admitted to the intensive care unit (ICU for mechanical ventilation for 24 hours, or more, because of one or more disease conditions associated with increased risk of developing ARDS. Exclusion criteria: age below 18 years; cardiac disease. We sampled plasma prospectively and compared patients who developed ARDS with those who did not using descriptive statistics and chi-square analysis of baseline demographical and clinical data. We also analyzed plasma concentrations of TF, t-PA and PAI-1 at inclusion (T0 and on third (T3 and seventh day (T7 of the ICU stay with non-parametric statistics inclusive their sensitivity and specificity associated with the development of ARDS using receiver operating characteristic (ROC curve analysis. Statistical significance: p < 0.05.Results: Of 24 patients at risk, six developed mild ARDS and four of each moderate or severe ARDS, respectively, 3 ± 2 (Mean ± SD days after inclusion. Median plasma concentrations of TF and PAI-1 were significantly higher at T7 in patients with ARDS, as compared to non-ARDS. Simultaneously, we found moderate correlations between plasma concentrations of TF and PAI-1, TF and PaO2/FiO2 and PEEP and TF. TF plasma concentration was associated with ARDS with 71% sensitivity and 100% specificity, a cut off level of 145 pg/ml and AUC 0

  14. Mission X: Train Like an Astronaut Pilot Study

    Science.gov (United States)

    Lloyd, Charles W.; Olivotto, C.; Boese, A.; Spiero, F.; Galoforo, G.; Niihori, M.

    2011-01-01

    Mission X: Train Like an Astronaut is an international educational challenge focusing on fitness and nutrition as we encourage students to "train like an astronaut." Teams of students (aged 8-12) learn principles of healthy eating and exercise, compete for points by finishing training modules, and get excited about their future as "fit explorers." The 18 core exercises (targeting strength, endurance, coordination, balance, spatial awareness, and more) involve the same types of skills that astronauts learn in their training and use in spaceflight. This first-of-its-kind cooperative outreach program has allowed 14 space agencies and various partner institutions to work together to address quality health/fitness education, challenge students to be more physically active, increase awareness of the importance of lifelong health and fitness, teach students how fitness plays a vital role in human performance for exploration, and inspire and motivate students to pursue careers in STEM fields. The project was initiated in 2009 in response to a request by the International Space Life Sciences Working Group. USA, Netherlands, Italy, France, Germany, Austria, Colombia, Spain, and United Kingdom hosted teams for the pilot this past spring, and Japan held a modified version of the challenge. Several more agencies provided input into the preparations. Competing on 131 teams, more than 3700 students from 40 cities worldwide participated in the first round of Mission X. OUTCOMES AND BEST PRACTICES Members of the Mission X core team will highlight the outcomes of this international educational outreach pilot project, show video highlights of the challenge, provide the working group s initial assessment of the project and discuss the future potential of the effort. The team will also discuss ideas and best practices for international partnership in education outreach efforts from various agency perspectives and experiences

  15. Dysphonia: medical treatment and a medical voice hygiene advice approach. A prospective randomised pilot study.

    Science.gov (United States)

    Pedersen, M; Beranova, A; Møller, S

    2004-07-01

    For many years all patients with dysphonia referred to in the literature as resulting from non-organic (functional) voice disorders were sent to speech therapy. Medical diagnoses were not taken into account. In our earlier Cochrane review on vocal cord nodules we discovered that evidence-based research in the area of benign voice disorders with dysphonia, and with or without slight benign swellings including nodules on the vocal cords, was lacking at that time. Therefore, a prospective randomised pilot study based on our Cochrane review has been made on dysphonic patients with non-organic (function provoked?) voice disorders as the basis for further evidence-based studies. Medical treatment was based on the scientific approach that once a micro-organic disorder caused by reflux, infection, allergy or environmental irritatants (e.g., dust or noise in the workplace) was discovered by very careful anamnesis and systematic objective routine analyses and was treated effectively, with documentation, the non-organic voice disorder disappeared, as, e.g., in the case of a diagnosis and treatment of helicobakter pylori. The reason is that the mucosal swelling/dysfunction of the vocal cords is secondary. In order to try to understand why the recommendation to all these patients for many years was only voice therapy, which the speech therapists "felt to be effective", updated voice-hygiene advice (for posture, accents of the diaphragm, intonation pattern and resonance) was given by experienced laryngologists, randomised with the updated medical diagnosis/therapy in order to elucidate what effect the training might have. No evidence-based studies in the literature document any effect. The crucial point seemed to be that doctors mostly did not examine any other diagnoses other than the "dysphonia" and did not dig down to any of the medical reasons when the vocal fold diagnosis of "non- organic disorders" was made. This should be changed in the future. This pilot study was based

  16. Biomechanical podiatric evaluation in an Italian cohort of patients with systemic sclerosis: A pilot study

    Science.gov (United States)

    Maddali Bongi, Susanna; Ravenni, Giovanni; Ciampi, Benedetta; Del Rosso, Angela; El Aoufy, Khadija

    2016-01-01

    Objective Foot problems are often present in Systemic Sclerosis (SSc) patients, however studies regarding podiatric problems related to SSc are lacking and there are no data evaluating the foot biomechanical changes. The aim of the present pilot study was to evaluate podiatric problems in an Italian cohort of SSc patients by assessing received podiatric services, foot pain and disability and biomechanical foot deformity. Material and Methods 25 consecutive SSc patients were enrolled from the Division of Rheumatology, University of Florence. All SSc patients were assessed by: Standards of Care for People with Foot Musculoskeletal Health problems: Audit Tool, Foot Function Index (FFI), Weight and non-weight bearing foot joint assessment, (Foot Posture Index (FPI) and Gait Cycle), Health Assessment Questionnaire (HAQ) and Medical Outcomes Survey Short Form 36 (SF-36). Results Audit Tool - Only 7 (28%) out of the 25 patients with SSc had a specific podiatric assessment and treatment: no patient received a foot health assessment within the first 6 months of disease diagnosis and no patient received information about foot involvement. 1 patient (4%) received foot assessment every year; 1 patient (4%) received specific information about the disease and 5 patients (20%) received information about the benefits of using adapted footwear and insoles. FFI - Values of pain, disability and activity limitations, reported in FFI, are 4.7±5.1, 5.1±3.2 and 3.2±3.1 (M±DS), respectively. Non-weight bearing foot joint assessment shows a rearfoot varus deformity in 64% of patients, forefoot varus deformity in 42% and 6% forefoot valgus deformity. Weight bearing foot joint assessment, through FPI shows a pronated foot 20% of patients with and 34% with highly pronated overall foot posture. Gait analysis shows that 64% of patients has a contact of the calcaneus in invertion while 36% in eversion. In the midstance, 78% have the foot in pronation and 22% in supination, while in

  17. Final Report on Pilot Studies / Final Report on Classroom Research with STEM and TESL Assessment

    DEFF Research Database (Denmark)

    Biel, Carmen; Wake, Jo Dugstad; Hesse, Friedrich

    This Deliverable is the final report on pilot studies within the NEXT-TELL project (D6.7) and furthermore comprises the Deliverable on Classroom Research with STEM and TESL Assessment (D2.9) in order to avoid redundancies between those two Deliverables.......This Deliverable is the final report on pilot studies within the NEXT-TELL project (D6.7) and furthermore comprises the Deliverable on Classroom Research with STEM and TESL Assessment (D2.9) in order to avoid redundancies between those two Deliverables....

  18. Case studies of energy efficiency financing in the original five pilot states, 1993-1996

    Energy Technology Data Exchange (ETDEWEB)

    Farhar, B C; Collins, N E; Walsh, R W

    1997-05-01

    The purpose of this report is to document progress in state-level programs in energy efficiency financing programs that are linked with home energy rating systems. Case studies are presented of programs in five states using a federal pilot program to amortize the costs of home energy improvements. The case studies present background information, describe the states` program, list preliminary evaluation data and findings, and discuss problems and solution encountered in the programs. A comparison of experiences in pilot states will be used to provide guidelines for program implementers, federal agencies, and Congress. 5 refs.

  19. Resource Allocation Support System (RASS): Summary report of the 1992 pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Buehring, W.A.; Whitfield, R.G.; Wolsko, T.D.; Kier, P.H.; Absil, M.J.G.; Jusko, M.J.; Sapinski, P.F.

    1993-02-01

    The Resource Allocation Support System (RASS) is a decision-aiding system being developed to assist the US Department of Energy`s (DOE`s) Office of Waste Management in program and budget decision making. Four pilot studies were conducted at DOE field offices in summer 1992 to evaluate and improve the RASS design. This report summarizes the combined results of the individual field office pilot studies. Results are presented from different perspectives to illustrate the type of information that would be available from RASS. Lessons learned and directions for future RASS developments are also presented.

  20. A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder

    DEFF Research Database (Denmark)

    DeVocht, James W; Goertz, Christine M; Hondras, Maria;

    2013-01-01

    BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80 particip......BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80...... that will provide clinicians with information that should be helpful when discussing treatment options for patients with TMD....

  1. Treating skin tears in nursing home residents: a pilot study comparing four types of dressings.

    Science.gov (United States)

    Edwards, H; Gaskill, D; Nash, R

    1998-03-01

    A pilot study was conducted to compare four types of dressings used to treat skin tears in nursing home residents. Wounds treated with a non-occlusive dressing healed more quickly than those dressed with occlusive dressings. The results suggest that ease of use and product wastage are important considerations when treating skin tears. The pilot study also highlights the need for further research into skin tear management and the need for ongoing education for nurses regarding skin integrity risk assessment and product information.

  2. Surgery versus Active Monitoring in Intermittent Exotropia (SamExo: study protocol for a pilot randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Buck Deborah

    2012-10-01

    Full Text Available Abstract Background Childhood intermittent exotropia [X(T] is a type of strabismus (squint in which one eye deviates outward at times, usually when the child is tired. It may progress to a permanent squint, loss of stereovision and/or amblyopia (reduced vision. Treatment options for X(T include eye patches, glasses, surgery and active monitoring. There is no consensus regarding how this condition should be managed, and even when surgery is the preferred option clinicians disagree as to the optimal timing. Reports on the natural history of X(T are limited, and there is no randomised controlled trial (RCT evidence on the effectiveness or efficiency of surgery compared with active monitoring. The SamExo (Surgery versus Active Monitoring in Intermittent Exotropia pilot study has been designed to test the feasibility of such a trial in the UK. Methods Design: an external pilot patient randomised controlled trial. Setting: four UK secondary ophthalmology care facilities at Newcastle NHS Hospitals Foundation Trust, Sunderland Eye Infirmary, Moorfields Eye Hospital and York NHS Trust. Participants: children aged between 6 months and 16 years referred with suspected and subsequently diagnosed X(T. Recruitment target is a total of 144 children over a 9-month period, with 120 retained by 9-month outcome visit. Randomisation: permuted blocks stratified by collaborating centre, age and severity of X(T. Interventions: initial clinical assessment; randomisation (eye muscle surgery or active monitoring; 3-, 6- and 9-month (primary outcome clinical assessments; participant/proxy completed questionnaire covering time and travel costs, health services use and quality of life (Intermittent Exotropia Questionnaire; qualitative interviews with parents to establish reasons for agreeing or declining participation in the pilot trial. Outcomes: recruitment and retention rates; nature and extent of participation bias; nature and extent of biases arising from crossover or

  3. A pilot study of immune and mood outcomes of a community-based intervention for dementia caregivers: the PLST intervention.

    Science.gov (United States)

    Garand, Linda; Buckwalter, Kathleen C; Lubaroff, David; Tripp-Reimer, Toni; Frantz, Rita A; Ansley, Timothy N

    2002-08-01

    Providing care to a family member with dementia is conceptualized as a chronic stressor with adverse psychological and physical effects. The purpose of this pilot study was to evaluate mood and immune outcomes of caregivers exposed to a community-based psychoeducational nursing intervention based on the progressively lowered stress threshold (PLST) model. The PLST intervention is designed to strengthen the psychological resources of dementia caregivers by teaching methods of preventing and/or managing behavioral problems exhibited by the person with dementia. Mood and immune outcomes were compared between caregivers randomly assigned to receive either the PLST or a comparison intervention. Results of this pilot study suggest that caregivers who received the PLST intervention showed significantly stronger T-cell proliferative responses to both PHA and ConA, indicating an improvement in T-cell immune function immediately after the in-home intervention (T2) and again after 6 months of telephone support for application of the PLST model (T3). Findings do not support the hypothesis that the PLST intervention had a significant effect on total mood disturbance or natural killer cell cytotoxicity over the course of the study.

  4. Can egg donor selection be improved? - a pilot study

    Directory of Open Access Journals (Sweden)

    Weghofer Andrea

    2010-06-01

    Full Text Available Abstract Background Accurate assessments of ovarian reserve (OR in egg donor candidates are crucial for maximal donor selection. This study assesses whether recently reported new methods of OR assessment by age-specific (as-, rather than non-as (nas- hormones, follicle stimulating hormone (FSH and anti-Müllerian hormone (AMH, and triple nucleotide (CGG repeats on the FMR1 (fragile X gene have the potential of improving egg donor selection. Methods Seventy-three consecutive egg donor candidates (candidates, amongst those 21 who reached egg retrieval (donors, were prospectively investigated for as-FSH, as-AMH and number of CGG repeats. Abnormal findings were assessed in candidates and donors and oocyte yields in the latter were statistically associated with abnormal FSH and AMH (>/ Results Amongst candidates mean as-AMH was 3.8 +/- 2.8 ng/mL (37.0% normal, 3.0 +/- 0.7 ng/mL; 26.6% low, 1.5 +/- 0.5 ng/mL; and 37.0% high, 5.8 +/- 2.2 ng/mL. AMH among donors was 4.2 +/- 1.7 ng/mL (33.3% normal, 14.3% low, and 52.4% high, yielding 17.8 +/- 7.2 oocytes, 42.9% in normal range (10-15, 9.5% in low (less than or equal to 9 and 47.6.% in high range (16-32. Candidates in 41.9% and donors in 38.1% demonstrated normal CGG counts; the remained were mostly heterozygous abnormal. Discussion Prospective assessment of even carefully prescreened candidates and donors still demonstrates shortcomings on both ends of the OR spectrum. Utilization of ovarian reserve testing methods, like as-hormones and CGG repeats on the FMR1 gene have potential of improving candidate selections.

  5. Effectiveness of a psychoeducational parenting group on child, parent, and family behavior: a pilot study in a family practice clinic with an underserved population.

    Science.gov (United States)

    Berge, Jerica M; Law, David D; Johnson, Jennifer; Wells, M Gawain

    2010-09-01

    Although integrated care for adults in primary care has steadily increased over the last several decades, there remains a paucity of research regarding integrated care for children in primary care. To report results of a pilot study testing initial feasibility of a parenting psychoeducational group targeting child behavioral problems within a primary care clinic. The participants (n = 35) were parents representing an underserved population from an inner-city primary care clinic. Participants attended a 12-week psychoeducational parenting group and reported pre- and post-measures of family functioning, child misbehavior and dyadic functioning. Paired t-tests and effects sizes are reported. Participants reported statistically significant improvement in family functioning, child misbehavior, and couple functioning after participating in the parenting psychoeducational group. Results suggest initial feasibility of a parenting psychoeducational group within a primary care clinic with an underserved population. This intervention may be useful for other primary care clinics seeking to offer more integrative care options for children and their families.

  6. Use of piloted simulation for studies of fighter departure/spin susceptibility

    Science.gov (United States)

    Gilbert, W. P.; Nguyen, L. T.

    1978-01-01

    The NASA-Langley Research Center has incorporated into its stall/spin research program on military airplanes the use of piloted, fixed-base simulation to complement the existing matrix of unique research testing techniques. The piloted simulations of fighter stall/departure flight dynamics are conducted on the Langley Differential Maneuvering Simulator (DMS). The objectives of the simulation research are reviewed. The rationale underlying the simulation methods and procedures used in the evaluation of airplane characteristics is presented. The evaluation steps used to assess fighter stall/departure characteristics are discussed. Simulation results are presented to illustrate the flight dynamics phenomena dealt with. The considerable experience accumulated in the conduct of piloted stall/departure simulation indicates that simulation provides a realistic evaluation of an airplane's maneuverability at high angles of attack and an assessment of the departure and spin susceptibility of the airplane. This realism is obtained by providing the pilot a complete simulation of the airplane and control system which can be flown using a realistic cockpit and visual display in simulations of demanding air combat maneuvering tasks. The use of the piloted simulation methods and procedures described were found very effective in identifying stability and control problem areas and in developing automatic control concepts to alleviate many of these problems. A good level of correlation between simulated flight dynamics and flight test results were obtained over the many fighter configurations studied in the simulator.

  7. Developing Emotional Literacy through Individual Dance Movement Therapy: A Pilot Study

    Science.gov (United States)

    Meekums, Bonnie

    2008-01-01

    This paper reports a pragmatic mixed methods pilot study of teacher perceptions regarding a school-based Dance Movement therapy (DMT) service for six children aged four to seven in a North of England primary school. No previous studies have systematically evaluated DMT in terms of the development of Emotional Literacy (EL), though theoretical…

  8. A Pilot Study of the Effects of Atomoxetine on Driving Performance in Adults with ADHD

    Science.gov (United States)

    Barkley, Russell A.; Anderson, Deborah L.; Kruesi, Markus

    2007-01-01

    Objective: There is a high risk of vehicular crashes, traffic citations, and poorer driving performance in adults with ADHD. This pilot study examines the value of a new nonstimulant (atomoxetine) for improving the driving performance of adults with ADHD. Method: Atomoxetine (1.2 mg/kg daily for 3 weeks) and a placebo are studied on 18 adults with…

  9. A Pilot Study of Integrated Listening Systems for Children with Sensory Processing Problems

    Science.gov (United States)

    Schoen, Sarah A.; Miller, Lucy J.; Sullivan, Jillian

    2015-01-01

    This pilot study explored the effects of Integrated Listening Systems (iLs) Focus Series on individualized parent goals for children with sensory processing impairments. A nonconcurrent multiple baseline, repeated measure across participants, single-case study design was employed (n = 7). The 40-session intervention was delivered at home and in…

  10. Psychosocial consequences for children of a parent with cancer : A pilot study

    NARCIS (Netherlands)

    Huizinga, GA; van der Graaf, WTA; Visser, A; Dijkstra, JS; Hoekstra-Weebers, JEHM

    2003-01-01

    When cancer is diagnosed in a parent, this may also have consequences for the children. The purpose of this pilot study was to gain more insight into the psychosocial consequences for children of a parent with cancer, from the perspective of both the children and their parents. For this study, 14 fa

  11. Managing Ethical Problems in Qualitative Research Involving Vulnerable Populations, Using a Pilot Study

    Directory of Open Access Journals (Sweden)

    Evalina van Wijk RN, PhD

    2013-02-01

    Full Text Available The purpose of the researcher's study was to examine the meaning that intimate partners of female rape victims attached to their lived experiences after the rape. The conduct of qualitative research concerning non-offending partners of female rape victims, however, often involves multifaceted ethical and practical challenges, which can be managed through the use of pilot studies. The pilot study described in this report had three objectives. The first was to pretest and refine the proposed method for locating, accessing, and recruiting intimate partners of female rape victims, within the first two weeks after the rape, for participation in a six-month longitudinal study. The second objective was to identify and prevent all possible risk factors in the proposed recruitment and data collection methods that could harm the participants' safety during the main study. The third objective was to determine the feasibility of the main study, in terms of the limited financial and human resources available. The pilot phase was valuable in identifying ethical and methodological problems during the recruitment of participants and collection of data. It allowed for methodological adjustments prior to the main study and confirmed the feasibility of the overall research design. A pilot, pretesting phase is therefore seen as an essential component of a qualitative study involving a vulnerable population.

  12. MEASURING QUALITY-OF-LIFE WITH THE SICKNESS IMPACT PROFILE - A PILOT-STUDY

    NARCIS (Netherlands)

    HULSEBOS, RG; BELTMAN, FW; MIRANDA, DD; SPANGENBERG, JFA

    1991-01-01

    A pilot-study was done to investigate the applicability of the sickness impact profile (SIP) in ex-ICU patients. For this study 221 consecutively admitted patients were reviewed retrospectively after excluding children, deceased patients and readmissions. SIP was assessed in these patients by either

  13. Cellular Phone Use in Class: Implications for Teaching and Learning a Pilot Study

    Science.gov (United States)

    Burns, Shari M.; Lohenry, Kevin

    2010-01-01

    Students equipped with the cell phones enter college classrooms daily. Realizing the impact of technology on fellow learners and faculty represents an area of concern. A pilot study was conducted to determine student and faculty perception regarding cellular phone use in the classroom. A quantitative descriptive study examined the perception of…

  14. Peer-Directed, Brief Mindfulness Training with Adolescents: A Pilot Study

    Science.gov (United States)

    Jennings, Samuel J.; Jennings, Jerry L.

    2013-01-01

    This pilot study studied the impact of brief mindfulness meditation training with adolescents. Whereas adult mindfulness training programs typically entail weekly 2.5 hour sessions over an eight week period, this program delivered four 50-minute sessions within a three week period. Each session was comprised of two mindfulness exercises delivered…

  15. Hearing Aids: Expectations and Satisfaction of People with an Intellectual Disability, a Descriptive Pilot Study

    Science.gov (United States)

    Meuwese-Jongejeugd, A.; Verschuure, H.; Evenhuis, H. M.

    2007-01-01

    Background: In spite of an increased risk of hearing impairment in persons with an intellectual disability (ID), rehabilitation with hearing aids often fails. We performed a descriptive pilot study with the following study questions: (1) Do comparable elements as in the general population contribute to expectations of and satisfaction with hearing…

  16. Reducing State Communication Anxiety for Public Speakers: An Energy Psychology Pilot Study

    Science.gov (United States)

    Fitch, John, III; Schmuldt, Laura; Rudick, Karen L.

    2011-01-01

    This mixed-method pilot study investigates the efficacy of implementing primordial energy activation and transcendence to address public speaking anxiety. Speech anxiety was significantly reduced from pretest to posttest, as measured by the Communication Anxiety Inventory State. Suggestions for future research, limitations of the current study,…

  17. Students' Perception of the Personal Characteristics of Ideal Teacher (I). Pilot Study

    Science.gov (United States)

    Vlad, Iulia-Elena; Ciascai, Liliana

    2014-01-01

    The current study presents part of the results of a pilot study that aimed the development of a profile for a teacher that is appreciated by school and university students. For the investigation, a 40 items questionnaire based on literature was used. The questionnaire was applied to 76 subjects (school and undergraduate students). The results…

  18. Emerging Literacy in Spanish among Hispanic Heritage Language University Students in the USA: A Pilot Study

    Science.gov (United States)

    Fairclough, Marta; Belpoliti, Flavia

    2016-01-01

    This pilot study identifies some lexical aspects of the emerging writing skills in Spanish among receptive English/Spanish bilingual students with little or no exposure to formal study of the home language upon entering a Spanish Heritage Language Program at a large public university in the Southwestern United States. The 200+ essays analyzed in…

  19. A pilot study of rivastigmine in the treatment of delirium after stroke : A safe alternative

    NARCIS (Netherlands)

    Oldenbeuving, Annemarie W.; de Kort, Paul L. M.; Jansen, Ben P. W.; Kappelle, Jaap; Roks, Gerwin

    2008-01-01

    Background: Delirium is a common disorder in the early phase of stroke. Given the presumed cholinergic deficiency in delirium, we tested treatment with the acetylcholinesterase inhibitor rivastigmine. Methods: This pilot study was performed within an epidemiological study. In 527 consecutive stroke

  20. Introduction of the Utrecht Tasks for Attention in Toddlers Using Eye Tracking (UTATE) : A Pilot Study

    NARCIS (Netherlands)

    de Jong, Marjanneke; Verhoeven, Marjolein; Hooge, Ignace T C; van Baar, Anneloes L

    2016-01-01

    Attention capacities underlie everyday functioning from an early age onwards. Little is known about attentional processes at toddler age. A feasible assessment of attention capacities at toddler age is needed to allow further study of attention development. In this study, a test battery is piloted t

  1. Careers of Professional Staff in Australian and UK Universities: A Mixed Methods Pilot Study

    Science.gov (United States)

    Gander, Michelle

    2017-01-01

    This article confirms the reliability of a protean and boundaryless career attitudes scale, tested in a pilot study. Additionally, it summarises the results of this study into the career attitudes of professional staff in Australian and UK universities. A mixed methods approach was taken using a survey consisting of both closed questions on a…

  2. A novel, online social cognitive training program for young adults with schizophrenia: A pilot study

    Directory of Open Access Journals (Sweden)

    Mor Nahum

    2014-03-01

    Conclusion: This study provides an initial proof of concept for online social cognition training in schizophrenia. This form of training demonstrated feasibility and resulted in within-subject gains in social functioning and motivation. This pilot study represents a first step towards validating this training approach; randomized controlled trials, now underway, are designed to confirm and extend these findings.

  3. Effects of Distance Coaching on Teachers' Use of Pyramid Model Practices: A Pilot Study

    Science.gov (United States)

    Artman-Meeker, Kathleen; Hemmeter, Mary Louise; Snyder, Patricia

    2014-01-01

    The purpose of this pilot study was to compare the effects of 2 professional development approaches on teachers' implementation of the "Pyramid" model, a classroom-wide approach for fostering social-emotional development and addressing challenging behavior. The study had 2 goals: (a) to examine the differential effects of workshop…

  4. NATO/CCMS PILOT STUDY CLEAN PRODUCTS AND PROCESSES (PHASE II) 2003 ANNUAL REPORT

    Science.gov (United States)

    The 6th annual meeting of the NATO CCMS Pilot Study, Clean Products and Processes, was held in Cetraro, Italy, from May 11 to 15, 2003. This was also the first meeting of its Phase II study. 24 country representatives attended this meeting. This meeting was very ably run by th...

  5. Cancer, Employment, and American Indians: A Participatory Action Research Pilot Study

    Science.gov (United States)

    Johnson, Sharon R.; Finifrock, DeAnna; Marshall, Catherine A.; Jaakola, Julia; Setterquist, Janette; Burross, Heidi L.; Hodge, Felicia Schanche

    2011-01-01

    American Indian cancer survivors are an underserved and understudied group. In this pilot study we attempted to address, through participatory action research, missing information about those factors that serve to either facilitate employment or hinder it for adult cancer survivors. One task of the study was to develop and/or modify…

  6. Azithromycin in the extremely low birth weight infant for the prevention of Bronchopulmonary Dysplasia: a pilot study

    Directory of Open Access Journals (Sweden)

    Anstead Michael I

    2007-06-01

    Full Text Available Abstract Background Azithromycin reduces the severity of illness in patients with inflammatory lung disease such as cystic fibrosis and diffuse panbronchiolitis. Bronchopulmonary dysplasia (BPD is a pulmonary disorder which causes significant morbidity and mortality in premature infants. BPD is pathologically characterized by inflammation, fibrosis and impaired alveolar development. The purpose of this study was to obtain pilot data on the effectiveness and safety of prophylactic azithromycin in reducing the incidence and severity of BPD in an extremely low birth weight (≤ 1000 grams population. Methods Infants ≤ 1000 g birth weight admitted to the University of Kentucky Neonatal Intensive Care Unit (level III, regional referral center from 9/1/02-6/30/03 were eligible for this pilot study. The pilot study was double-blinded, randomized, and placebo-controlled. Infants were randomized to treatment or placebo within 12 hours of beginning mechanical ventilation (IMV and within 72 hours of birth. The treatment group received azithromycin 10 mg/kg/day for 7 days followed by 5 mg/kg/day for the duration of the study. Azithromycin or placebo was continued until the infant no longer required IMV or supplemental oxygen, to a maximum of 6 weeks. Primary endpoints were incidence of BPD as defined by oxygen requirement at 36 weeks gestation, post-natal steroid use, days of IMV, and mortality. Data was analyzed by intention to treat using Chi-square and ANOVA. Results A total of 43 extremely premature infants were enrolled in this pilot study. Mean gestational age and birth weight were similar between groups. Mortality, incidence of BPD, days of IMV, and other morbidities were not significantly different between groups. Post-natal steroid use was significantly less in the treatment group [31% (6/19] vs. placebo group [62% (10/16] (p = 0.05. Duration of mechanical ventilation was significantly less in treatment survivors, with a median of 13 days (1–47

  7. Sexual and reproductive health issues facing Southeast Asian beer promoters: a qualitative pilot study

    Directory of Open Access Journals (Sweden)

    Spitzer Denise L

    2010-07-01

    Full Text Available Abstract Background In Southeast Asia, hundreds of thousands of young rural women migrate from their villages to the larger cities in search of work. Many find employment with beer companies or in the clubs where beer is sold, promoting the sale of beer. Previous research suggests these young migrants are in a highly vulnerable position. This paper will describe the findings of an October 2009 meeting to develop a research agenda on the sexual and reproductive health of beer promoters and a subsequent pilot study of focus groups with beer promoters to review this agenda. Methods Participants of the research meeting representing beer promoters, academics, non-governmental organizations (NGOs, government and the beer industry from Cambodia, Thailand, Laos, and Vietnam collaborated in the development of three key research themes. The themes were verified in focus group discussions with beer promoters organized by local research partners in all four countries. The focus group participants were asked what they felt were the key sexual and reproductive health issues facing them in a non-directive and unstructured manner, and then asked to comment more specifically on the research priorities developed at the meeting. The focus groups were recorded digitally, transcribed, and translated into English. The data were analyzed by coding for common themes and then developing matrices to compare themes between groups. Results The participants of the meeting identified three key research themes: occupational health (including harassment and violence, working conditions, and fair pay, gender and social norms (focusing on the impact of power relations between the genders on women's health, and reproductive health (knowledge and access to reproductive health care services. The participants in the focus groups in all four countries agreed that these were key priorities for them, though the emphasis on the most important issues varied between groups of women

  8. Facilitating Interprofessional Collaboration through ePortfolio: A Pilot Study

    Science.gov (United States)

    Karsten, Kathleen; McMillan Coddington, Deborah; Lehman, Regina M.; Pierce, Cynthia; Tom, May; Gallo-Silver, Les

    2015-01-01

    Each member of the healthcare team has been trained with specific knowledge and skills. Quality patient care is dependent on the collaboration of the various healthcare professionals and their ability to work as a team. In order to be effective, interprofessional collaboration should be included in the academic preparation of each of the various…

  9. Lessons learned on approaches to data collection and analysis from a pilot study.

    Science.gov (United States)

    Watson, Fiona Alice

    2016-09-01

    Background Pilot studies are more commonly associated with quantitative research, and their use is under-reported in qualitative approaches. This paper discusses the value of undertaking a pilot study in a doctoral research project to examine nursing students' understanding of recovery in mental health by adopting what is called a phenomenographic approach, which in research is concerned with the variation in how particular phenomena are experienced. Aim To explore the usefulness of three different methods of collecting data - interviewing, completed exam papers and a written response to a scenario - and the Dahlgren and Fallsberg ( 1991 ) framework for phenomenographic data analysis. Discussion Methodological issues experienced during the collection and analysis of data in the project are discussed. Conclusion The pilot study provided an opportunity for valuable insights to be gained into the methodological issues related to phenomenography and to revise the research plan for the larger study. Implications for practice While it may not be generalised to other qualitative studies, this paper may help others undertaking studies that adopt this approach and points to the general value of pilot studies in qualitative research.

  10. Study and Pilot Scale Development of Catalyst for Ethylebenzene Synthesis Through Transalkylation of Benzene and Polyethylbenzene

    Institute of Scientific and Technical Information of China (English)

    Wang Jin; Zhang Fengmei; Li Minglin; Hao Xiaoming; Shu Xingtian; He Mingyuan

    2002-01-01

    This paper refers to the results of study and development of benzene and polyethylbenzene transalkylation catalyst (type AEB-1) for synthesis of ethylbenzene. The effect of reaction conditions on the reaction performance of the catalyst was investigated in the pressurized microreactor CDS-900. A transalkylation catalyst with high activity, good selectivity and stability was developed following a 2000-hour test on the activity and stability of the catalyst. The preparation of this catalyst was implemented in pilot scale and this catalyst was tested for activity and stability in a 150 t/a pilot unit for production of ethylbenzene. The test results have shown that this transalkylation catalyst has excellent activity, selectivity and stability. The operation of pilot test unit ran smoothly and the process scheme is viable.

  11. Conflict management in public university hospitals in Turkey: a pilot study.

    Science.gov (United States)

    Tengilimoglu, Dilaver; Kisa, Adnan

    2005-01-01

    By nature, hospitals are extremely complex organizations, combining many different professional groups within an intricate administrative structure. Conflicts therefore expectedly arise between individuals, groups, and departments. It is in the interest of health care administrators to periodically assess the major factors giving rise to these conflicts. In this study, a questionnaire designed to measure sources of conflict in the workplace was completed by 204 staff members at Gazi University Hospital. Of the participants, 30.9% were physicians, and 12.5% were administrators at various levels; 61.5% were female, and 38.5% were male. In terms of work experience, 52.6% of participants had worked less than 5 years at the hospital. The results of the study show that educational differences among the hospital staff were a major barrier to good communication and information flow between groups. Professionals in the same specialties experienced fewer conflicts. Another source of conflict was that resource allocation was considered unfair across departments. Although the hospital management provided an ombudsman for staff concerns, staff rarely resorted to the ombudsman because of the stigma associated with complaining. A lack of opportunity for career advancement was mentioned by 52% of the participants as a source of conflict. At present, job performance and rewards are not closely related in public university hospitals in Turkey because promotions and pay raises are strictly limited by law. Bureaucracy was also perceived to be a source of conflict, with 48.4% of participants saying that their performance was less than optimal because of the presence of multiple supervisors. This pilot study suggests that in Turkey, legislative reform is needed to give public university hospitals more flexibility regarding work incentives, open-door policies at the administrative level, and social interactions to improve teamwork among hospital staff.

  12. Intervention with vitamins in patients with nonproliferative diabetic retinopathy: a pilot study

    Directory of Open Access Journals (Sweden)

    Smolek MK

    2013-07-01

    Full Text Available Michael K Smolek,1 Neil F Notaroberto,1,2 Arley G Jaramillo,1,2 Lisa R Pradillo1,2 1CLEVER Eye Institute, 2EyeCare 20/20, Slidell, LA, USA Background: The purpose of this study was to determine whether a combination of vitamins B6, B9, and B12 is an effective intervention for reducing the signs and symptoms of nonproliferative diabetic retinopathy. Methods: Ten subjects with type 2 diabetes mellitus (n = 20 eyes with clinically diagnosed mild to moderate nonproliferative diabetic retinopathy were recruited from a private practice ophthalmology clinic for this open-label, uncontrolled, prospective six-month study. Metanx® vitamin tablets (containing 3 mg L-methylfolate calcium, 35 mg pyridoxal-5′-phosphate, and 2 mg methylcobalamin were administered at a dosage of two tablets daily. Primary outcome indicators were the percent change in mean retinal sensitivity threshold measured by macular microperimetry and the percent change in mean central retinal thickness measured by spectral-domain optical coherence tomography. Results: Three subjects were lost to follow-up. In the remaining seven subjects, two of 14 eyes had foveal edema that prevented microperimetry measurements due to poor fixation. The remaining 12 eyes showed a nonlinear improvement in mean threshold retinal sensitivity (P < 0.001. Overall change in mean central retinal thickness in 14 eyes was linear (R2 = 0.625; P = 0.034, with a significant reduction between one and six months (P = 0.012. Conclusion: In this pilot study, the Metanx intervention appeared to have some beneficial effects with respect to reducing retinal edema and increasing light sensitivity in subjects with nonproliferative diabetic retinopathy. Keywords: diabetes, diabetic retinopathy, vitamin B, homocysteine, nitric oxide, microperimetry

  13. Exhaled nitric oxide and urinary EPX levels in infants: a pilot study

    Directory of Open Access Journals (Sweden)

    Olin Anna-Carin

    2011-05-01

    Full Text Available Abstract Background Objective markers of early airway inflammation in infants are not established but are of great interest in a scientific setting. Exhaled nitric oxide (FeNO and urinary eosinophilic protein X (uEPX are a two such interesting markers. Objective To investigate the feasibility of measuring FeNO and uEPX in infants and their mothers and to determine if any relations between these two variables and environmental factors can be seen in a small sample size. This was conducted as a pilot study for the ongoing Swedish Environmental Longitudinal Mother and child Asthma and allergy study (SELMA. Methods Consecutive infants between two and six months old and their mothers at children's health care centres were invited, and 110 mother-infant pairs participated. FeNO and uEPX were analysed in both mothers and infants. FeNO was analyzed in the mothers online by the use of the handheld Niox Mino device and in the infants offline from exhaled air sampled during tidal breathing. A 33-question multiple-choice questionnaire that dealt with symptoms of allergic disease, heredity, and housing characteristics was used. Results FeNO levels were reduced in infants with a history of upper respiratory symptoms during the previous two weeks (p Conclusion The use of uEPX as a marker of early inflammation was not supported. FeNO levels in infants were associated to windowpane condensation. Measuring FeNO by the present method may be an interesting way of evaluating early airway inflammation. In a major population study, however, the method is difficult to use, for practical reasons.

  14. Barriers, facilitators and attitudes influencing health promotion activities in general practice: an explorative pilot study

    Directory of Open Access Journals (Sweden)

    Geense Wytske W

    2013-02-01

    Full Text Available Abstract Background The number of chronically ill patients increases every year. This is partly due to an unhealthy lifestyle. However, the frequency and quality of (evidence-based health promotion activities conducted by Dutch general practitioners (GPs and practice nurses (PNs are limited. The aim of this pilot study was to explore which lifestyle interventions Dutch GPs and PNs carry out in primary care, which barriers and facilitators can be identified and what main topics are with respect to attitudes towards health promoting activities. These topic areas will be identified for a future, larger scale study. Method This qualitative study consisted of 25 semi-structured interviews with sixteen GPs and nine PNs. ATLAS.ti was used to analyse the transcripts of the interviews. Results All GPs and PNs said they discuss lifestyle with their patients. Next to this, GPs and PNs counsel patients, and/or refer them to other disciplines. Only few said they refer patients to specific lifestyle programs or interventions in their own practice or in the neighbourhood. Several barriers and facilitators were identified. The main topics as barriers are: a lack of patients’ motivation to make lifestyle changes, insufficient reimbursement, a lack of proven effectiveness of interventions and a lack of overview of health promoting programs in their neighbourhood. The most cited facilitators are availability of a PN, collaboration with other disciplines and availability of interventions in their own practice. With respect to attitudes, six different types of GPs were identified reflecting the main topics that relate to attitudes, varying from ‘ignorer’ to ‘nurturer’. The topics relating to PNs attitudes towards health promotion activities, were almost unanimously positive. Conclusion GPs and PNs all say they discuss lifestyle issues with their patients, but the health promotion activities that are organized in their practice vary. Main topics that hinder

  15. Use of a Data-Linked Weather Information Display and Effects on Pilot Navigation Decision Making in a Piloted Simulation Study

    Science.gov (United States)

    Yuchnovicz, Daniel E.; Novacek, Paul F.; Burgess, Malcolm A.; Heck, Michael L.; Stokes, Alan F.

    2001-01-01

    This study provides recommendations to the FAA and to prospective manufacturers based on an exploration of the effects of data link weather displays upon pilot decision performance. An experiment was conducted with twenty-four current instrument rated pilots who were divided into two equal groups and presented with a challenging but realistic flight scenario involving weather containing significant embedded convective activity. All flights were flown in a full-mission simulation facility within instrument meteorological conditions. The inflight weather display depicted NexRad images, graphical METARs and textual METARs. The objective was to investigate the potential for misuse of a weather display, and incorporate recommendations for the design and use of these displays. The primary conclusion of the study found that the inflight weather display did not improve weather avoidance decision making. Some of the reasons to support this finding include: the pilot's inability to easily perceive their proximity to the storms, increased workload and difficulty in deciphering METAR textual data. The compelling nature of a graphical weather display caused many pilots to reduce their reliance on corroborating weather information from other sources. Minor changes to the weather display could improve the ability of a pilot to make better decisions on hazard avoidance.

  16. A Study on Protection of Cables by Solkor Differential Protection Relay with Fibre Optic Pilot Wireor Metallic Pilot Wire

    Directory of Open Access Journals (Sweden)

    Ahmed Rashad .E. Bakr

    2015-02-01

    Full Text Available This paper intends to briefly compare the protection of buried three phase high voltage cable with Solkordifferential protection relay using metallic pilot wires orfibre optic pilot wires. Dielectric property of the fiber optic provides complete electrical isolation as well as interference free signaling. This provides total immunity from GPR (ground potential rise, longitudinal induction, and differential mode noise coupling andhigh-voltage hazards to personnel safety. So Fibre optic provides great advantage for Solkor differential protection relaying.

  17. Extending decision making competence to special populations: a pilot study of persons on the autism spectrum

    OpenAIRE

    Levin, Irwin P; Gary J Gaeth; Foley-Nicpon, Megan; Yegorova, Vitaliya; Cederberg, Charles; Yan, Haoyang

    2015-01-01

    The area of decision making has much to offer in our effort to understand special populations. This pilot study is an example of just such a project, where we illustrate how traditional decision making tools and tasks can be used to uncover strengths and weaknesses within a growing population of young adults with autism. In this pilot project we extended accounts of autistic behavior such as those derived from “theory of mind” to predict key components of decision making in high-functioning y...

  18. Protein profile study of breast cancer tissues using HPLC-LIF: a pilot study

    Science.gov (United States)

    Menon, Suraj; Sujatha; Kumar, K. Kalyan; Kurien, Jacob; Krishnanand, B. R.; Mahato, K. K.; George, Sajan D.; Kartha, V. B.; C, Santhosh

    2007-02-01

    Proteomics based techniques are rapidly emerging as alternative techniques to conventional histo-pathological methods for detection and diagnosis of cancers. Tumor markers are of considerable importance in the study of various cancers. A study of various changes in the protein profile associated with breast cancer will facilitate a better understanding of the various dynamic changes associated with the disease. In our study we have used High Performance Liquid Chromatography coupled with highly sensitive Laser Induced Fluorescence for recording the protein profiles of breast tissue homogenates. The protein profiles were recorded from pathologically certified normal as well as malignant breast tissue samples. The recorded protein profiles were studied by using Principal Component Analysis. Good discrimination of normal, benign and malignant samples was achieved in this pilot study.

  19. A Study of Greek Teachers' Satisfaction with the Implementation of the European Pedagogical ICT License Pilot Course

    Science.gov (United States)

    Mouzakis, Charalambos; Roussakis, Ioannis; Tsagarissianos, George

    2010-01-01

    The survey presented in this study examines Greek teachers' satisfaction with the implementation of the European Pedagogical Information and Communication Technology License (EPICT) pilot course. A total of 51 primary and secondary education teachers participated in the study that followed the pilot course concerning the integration of ICT in the…

  20. Voorbereiding pilot studie ‘Power for Teens’ voor tieners met overgewicht en angstige en depressieve klachten.

    NARCIS (Netherlands)

    Bouwman, Miranda; Tuinstra, Jolanda; Visser, Marieke; Cox, R.F.A

    2015-01-01

    Abstract Het huidige onderzoek richtte zich op de voorbereidingen die nodig zijn voor het uitvoeren van een pilot studie van de interventie ‘Power for Teens’. Dit is een interventie voor jongeren met overgewicht, angstige en depressieve klachten en een lage self-efficacy. Voordat de pilot studie uit

  1. Pulsed Electromagnetic Field Assisted in vitro Electroporation: A Pilot Study

    Science.gov (United States)

    Novickij, Vitalij; Grainys, Audrius; Lastauskienė, Eglė; Kananavičiūtė, Rūta; Pamedytytė, Dovilė; Kalėdienė, Lilija; Novickij, Jurij; Miklavčič, Damijan

    2016-09-01

    Electroporation is a phenomenon occurring due to exposure of cells to Pulsed Electric Fields (PEF) which leads to increase of membrane permeability. Electroporation is used in medicine, biotechnology, and food processing. Recently, as an alternative to electroporation by PEF, Pulsed ElectroMagnetic Fields (PEMF) application causing similar biological effects was suggested. Since induced electric field in PEMF however is 2–3 magnitudes lower than in PEF electroporation, the membrane permeabilization mechanism remains hypothetical. We have designed pilot experiments where Saccharomyces cerevisiae and Candida lusitaniae cells were subjected to single 100–250 μs electrical pulse of 800 V with and without concomitant delivery of magnetic pulse (3, 6 and 9 T). As expected, after the PEF pulses only the number of Propidium Iodide (PI) fluorescent cells has increased, indicative of membrane permeabilization. We further show that single sub-millisecond magnetic field pulse did not cause detectable poration of yeast. Concomitant exposure of cells to pulsed electric (PEF) and magnetic field (PMF) however resulted in the increased number PI fluorescent cells and reduced viability. Our results show increased membrane permeability by PEF when combined with magnetic field pulse, which can explain electroporation at considerably lower electric field strengths induced by PEMF compared to classical electroporation.

  2. A conceptual framework for interprofessional shared decision making in home care: Protocol for a feasibility study

    Directory of Open Access Journals (Sweden)

    Murray Mary-Anne

    2011-01-01

    Full Text Available Abstract Background Shared decision making (SDM is fundamental to informed consent and client-centered care. So far, SDM frameworks have been limited to the client-physician dyad, even though care is increasingly delivered by interprofessional (IP teams. IP collaboration is especially essential in home care, one of health care's most rapidly growing areas. This study will assess whether it is possible to practice SDM in IP home care. Methods/Design We will use a qualitative case study and a quantitative survey to capture the macro, meso and micro levels of stakeholders in home care. The case study will follow the knowledge-to-action process framework to evaluate the work of an IP home care team at a Quebec City health center. Sources of data will include one-on-one interviews with patients, family caregivers or surrogates and significant others, and administrators; a focus group of home care health professionals; organizational documents; and government policies and standards. The interview guide for the interviews and the focus group will explore current practices and clinical problems addressed in home care; factors that could influence the implementation of the proposed IP approach to SDM; the face and content validity of the approach; and interventions to facilitate the implementation and evaluation of the approach. The survey will ask 300 health professionals working in home care at the health center to complete a questionnaire based on the Theory of Planned Behaviour that measures their intentions to engage in an IP approach to SDM. We will use our analysis of the individual interviews, the focus group and the survey to elaborate a toolkit for implementing an IP approach to SDM in home care. Finally, we will conduct a pilot study in Alberta to assess the transferability of our findings. Discussion We believe that developing tools to implement IP SDM in home care is essential to strengthening Canada's healthcare system and furthering

  3. Implementing Modular Interactive Tiles for Rehabilitation in Tanzania – a pilot study

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop; Jensen, Line Steiness Dejnbjerg; Ssessanga, Yusuf

    2014-01-01

    The pilot study in the Iringa region, Tanzania, indicates how the modular interactive tiles can be used for playful physical rehabilitation for many diverse patient groups (handicapped children, stroke, cardiac, diabetic patients, etc.) in both urban and rural areas, and how it motivates the user...

  4. A pilot study on acoustic regulations for schools – Comparison between selected countries in Europe

    DEFF Research Database (Denmark)

    Rasmussen, Birgit; Guigou-Carter, Catherine

    2016-01-01

    Acoustic regulations for schools exist in most countries in Europe, the main reasons being improving learning conditions for pupils and work conditions for teachers. As a pilot study, comparison between requirements in selected countries in Europe has been carried out. The findings show a diversi...

  5. [Somatic screening in child and adolescent psychiatry: a descriptive pilot study

    NARCIS (Netherlands)

    Muskens, J.B; Vermeulen, K.; Deurzen, P.A. van; Tomesen, E.M.; Gaag, R.J. van der; Buitelaar, J.; Staal, W.G.

    2015-01-01

    BACKGROUND: Somatic disorders occur more often in psychiatric patients than in the general population. Somatic symptoms can cause or increase psychiatric symptoms. Psychiatric symptoms and their treatment can have an effect on the physical state of the patient. A pilot study involving an adult outpa

  6. Photogrammetric Documentation of Regions of Interest at Autopsy—A Pilot Study

    DEFF Research Database (Denmark)

    Slot, Liselott Kristina; Larsen, Peter Kastmand; Lynnerup, Niels

    2014-01-01

    In this pilot study, the authors tested whether photogrammetry can replace or supplement physical measurements made during autopsies and, based on such measurements, whether virtual computer models may be applicable in forensic reconstructions. Photogrammetric and physical measurements of markers...... and the corpse is no longer available, is one of the biggest benefits of photogrammetry. © 2013 American Academy of Forensic Sciences....

  7. The Internet as a Source of Academic Research Information: Findings of Two Pilot Studies.

    Science.gov (United States)

    Kibirige, Harry M.; DePalo, Lisa

    2000-01-01

    Discussion of information available on the Internet focuses on two pilot studies that investigated how academic users perceive search engines and subject-oriented databases as sources of topical information. Highlights include information seeking behavior of academic users; undergraduate users; graduate users; faculty; and implications for…

  8. Shoulder pain and disability in daily life, following supraomohyoid neck dissection : a pilot study

    NARCIS (Netherlands)

    van Wilgen, CP; Dijkstra, PU; Nauta, JM; Vermey, A; Roodenburg, JLN

    2003-01-01

    Introduction: The purpose of this pilot study was to assess shoulder morbidity; i.e. pain and disability in daily activities, at least I year after unilateral or bilateral supraomohyoid neck dissection. Patients and methods: 52 patients having been subjected to a supraomohyoid neck dissection comple

  9. Conveying a Biblical Worldview to Charter School Students: A Pilot Study

    Science.gov (United States)

    Barke, Steve

    2014-01-01

    This doctoral project is a pilot study to assess the effectiveness of a church discipleship co-op designed to convey a biblical worldview to middle and high school students enrolled in charter homeschooling in Southern California. Research by the Nehemiah Institute indicated that 90% of Christian families in the United States send their children…

  10. A serious exergame for patients suffering from chronic musculoskeletal back and neck pain: a pilot study

    NARCIS (Netherlands)

    Kosterink, Stephanie M.; Huis in 't Veld, Rianne M.H.A.; Schönauer, Christian; Kaufmann, Hannes; Hermens, Hermie J.; Vollenbroek-Hutten, Miriam M.R.

    2013-01-01

    Introduction: Over recent years, the popularity of videogames has gone beyond youth and gamers and is slowly entering the field of professional healthcare. Exergames are an attractive alternative to physical therapy. The primary aim of this pilot study was to explore the user experience (usability,

  11. Gaming and conventional exercises for improvement of arm function after stroke: a randomised controlled pilot study

    NARCIS (Netherlands)

    Kottink, A.I.R.; Prange, G.B.; Krabben, T.; Rietman, J.S.; Buurke, J.H.

    2014-01-01

    Objective: The use of new technologies in rehabilitation, such as virtual reality and/or computerized gaming exercises, may be useful to enable patients to practice intensively in a motivating way. The objective of the present randomized controlled pilot study was to compare the effect of reach trai

  12. Multi-family treatment for patients with persistent auditory hallucinations and their relatives : a pilot study

    NARCIS (Netherlands)

    Jenner, JA; van de Willige, G; Wiersma, D

    2006-01-01

    Objective: To test feasibility and effectiveness of multi-family treatment (MFT) for patients with persistent auditory hallucinations. Method: A naturalistic pilot study with 6-month follow-up of 12 patients and 10 relatives. Pre- and post-treatment assessment concerned compliance, satisfaction, sub

  13. Iron Deficiency and the Cognitive and Psychomotor Development of Children: A Pilot Study with Institutionalized Children.

    Science.gov (United States)

    Driva, A.; And Others

    1985-01-01

    Describes a pilot study, involving 48 institutionalized infants and toddlers, which aimed to treat iron deficiency anemia and to discover other factors contributing to the problem. Results indicate improvement in cognitive development after the administration of iron among three groups, while no significant differences were observed in psychomotor…

  14. Transrectal ultrasound of the prostatic urethra related to urodynamically assessed urethral resistance. A pilot study

    NARCIS (Netherlands)

    R. van Mastrigt (Ron); R. Kranse (Ries); H. Jansen

    1994-01-01

    textabstractIn this pilot study on 17 men who underwent urodynamic investigation for various dysuric complaints, real-time transrectal ultrasonography (TRUS) was performed. From the images anatomical parameters were identified that correlated with obstructive urodynamic findings and urethral resista

  15. Are elementary school teachers prepared to tackle bullying? : A pilot study

    NARCIS (Netherlands)

    Oldenburg, Beau; Bosman, Rie; Veenstra, Rene

    2016-01-01

    The aim of this pilot study was to investigate to what extent elementary school teachers were prepared to tackle bullying. Interview data from 22 Dutch elementary school teachers (M age=43.3, 18 classrooms in eight schools) were combined with survey data from 373 students of these teachers (M age=10

  16. Association between plasma endocannabinoids and appetite in hemodialysis patients: a pilot study

    Science.gov (United States)

    Weight loss is a well-recognized complication in subjects undergoing hemodialysis for impaired kidney function. This pilot study explored whether plasma levels of compounds known to mediate appetite, the endocannabinoids (EC) and EC-like compounds derived from polyunsaturated fatty acids (PUFA), ar...

  17. A pilot study to profile the lower limb musculoskeletal health in children with obesity.

    LENUS (Irish Health Repository)

    O'Malley, Grace

    2012-01-01

    : Evidence suggests a negative effect of obesity on musculoskeletal health in children. A pilot study was undertaken to investigate the presence of musculoskeletal impairments in children with obesity and to explore the relationships among body mass index, physical activity, and musculoskeletal measures.

  18. Cognitive Behavioral Therapy for Depressed Adults with Mild Intellectual Disability: A Pilot Study

    Science.gov (United States)

    Hartley, Sigan L.; Esbensen, Anna J.; Shalev, Rebecca; Vincent, Lori B.; Mihaila, Iulia; Bussanich, Paige

    2015-01-01

    There is a paucity of research on psychosocial treatments for depression in adults with intellectual disability (ID). In this pilot study, we explored the efficacy of a group CBT treatment that involved a caregiver component in adults with mild ID with a depressive disorder. Sixteen adults with mild ID and a depressive disorder participated in a…

  19. Mindfulness for Teachers: A Pilot Study to Assess Effects on Stress, Burnout, and Teaching Efficacy

    Science.gov (United States)

    Flook, Lisa; Goldberg, Simon B.; Pinger, Laura; Bonus, Katherine; Davidson, Richard J.

    2013-01-01

    Despite the crucial role of teachers in fostering children's academic learning and social-emotional well-being, addressing teacher stress in the classroom remains a significant challenge in education. This study reports results from a randomized controlled pilot trial of a modified Mindfulness-Based Stress Reduction course (mMBSR) adapted…

  20. Exergames for unsupervised balance training at home: A pilot study in healthy older adults

    NARCIS (Netherlands)

    van Diest, Mike; Stegenga, Jan; Wörtche, Heinrich J.; Verkerke, Gijsbertus; Postema, Klaas; Lamoth, Claude

    2016-01-01

    Exercise videogames (exergames) are gaining popularity as tools for improving balance ability in older adults, yet few exergames are suitable for home-based use. The purpose of the current pilot study was to examine the effects of a 6-week unsupervised home-based exergaming training program on balan

  1. Lecturer Perspectives on Dyslexia within One Greek University: A Pilot Study

    Science.gov (United States)

    Stampoltzis, Aglaia; Tsitsou, Elisavet; Plesti, Helen; Kalouri, Rani

    2015-01-01

    Introduction: Dyslexia is a learning difficulty which affects people in different ways. During the last decades the number of students with dyslexia entering higher education increased steadily. Method: This paper reports a pilot study exploring the attitudes, views and experiences of faculty members at one small size Greek university regarding…

  2. Developmental Norms of Children Aged 2 1/2-5 Years: A Pilot Study.

    Science.gov (United States)

    Muralidharan, Rajalakshmi

    1969-01-01

    The purpose of this pilot study, aside from collection of developmental data on 38 nursery school children aged 2 1/2 to 5 years, was (1) to develop, modify and adapt the testing equipment used in Gesell's Developmental Schedule, in the field of motor, adaptive, language, and personal-social development; (2) to develop elaborate, exhaustive,…

  3. An animal model for oroantral communications : a pilot study with Gottingen minipigs

    NARCIS (Netherlands)

    van Minnen, B; Stegenga, B; Zuidema, J; Hissink, CE; van Leeuwen, MBM; van Kooten, TG; Bos, RRM

    2005-01-01

    A pilot study was performed to investigate whether the Gottingen minipig is a suitable animal model for creating and closing oroantral communications (OACs) and to test whether these defects can be closed with a biodegradable polyurethane (PU) foam. In three adult minipigs, an OAC was created on bot

  4. Marine Arctic Ecosystem Study (MARES): Pilot Project - Marine Mammal Tagging and Tracking

    Science.gov (United States)

    2015-09-30

    to locations and area travelled, the tags provide temperature , salinity , fluorescence, time spent hauled out, cruising, diving, dive parameters, and...1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Marine Arctic Ecosystem Study (MARES): Pilot Project...tagging bearded and spotted seals with satellite tags to measure the ocean environment and the movements of these species. Testing of animal capture and

  5. A Pilot Study of Using Jazz Warm Up Exercises in Primary School Choir in Hong Kong

    Science.gov (United States)

    Chen, Jason Chi Wai; Lee, Han Wai

    2013-01-01

    This pilot study is to examine whether it is valuable to implement jazz choral practice in Hong Kong primary school setting. The findings can serve as a reference to explore the possibilities of promoting jazz education in Asian countries or in China. The participants were 70 public primary school students from grade 2 to 5 in Hong Kong. All…

  6. A clinical pilot study of fresh frozen plasma versus human albumin in paediatric craniofacial repair

    NARCIS (Netherlands)

    Kerner, T.; Machottas, A.; Kerner, S.; Ahlers, O.; Haberl, H.; Riess, H.; Hildebrandt, B.

    2008-01-01

    Poediatric craniofacial surgery (pCFS) regularly requires transfusion of packed red blood cells (pRBC). In this clinical pilot study two different transfusion regimens were prospectively compared concerning pRBC transfusions, postoperative bleeding and other clinical parameters. Thirty infants (aged

  7. Beliefs of Applied Studio Faculty on Desirable Traits of Prospective Music Education Majors: A Pilot Study

    Science.gov (United States)

    Royston, Natalie Steele; Springer, D. Gregory

    2015-01-01

    The purpose of this pilot study was to examine the beliefs of applied music faculty on desirable traits of prospective music education majors. Researcher-designed surveys were sent electronically to applied music faculty at 12 National Association of Schools of Music-accredited institutions randomly selected from each of the four major divisions…

  8. A Pilot Study of Problems and Practices in the Induction of Beginning Teachers.

    Science.gov (United States)

    Bouchard, John B.; Hull, Ronald E.

    A pilot study was designed to test the practicality of gathering data through interviews and to provide tentative information on induction problems and practices encountered by beginning teachers in the Cattaraugus-Chautauqua County area of New York. Fifty-three elementary self-contained classroom teachers and secondary academic subject-matter…

  9. ShopTrip Pilot Study : The Preference-Conscious Choice Modelled and Observed

    DEFF Research Database (Denmark)

    Barratt, Daniel; Selsøe-Sørensen, Henrik; Qvistgaard, Francoise;

    The goal of the current pilot study was to construct and test a new kind of setup for observing the consumer’s purchasing behaviour, with a particular focus on fairness and misleadingness issues as opposed to marketing and sales. The setup described represents a compromise between ecological...

  10. A Pilot Study on the Impact of a Home-Based Parenting Intervention: Parents Plus

    Science.gov (United States)

    Byrne, Ellie; Holland, Sally; Jerzembek, Gabi

    2010-01-01

    This article reports on a pilot study undertaken in order to explore the impact of a home-based parenting intervention (Parents Plus), on parents and families. Parents Plus is part of a Welsh Early Years strategy called Flying Start and aims to promote positive parent-child interactions. This article explores the medium-term to long-term impact of…

  11. Cognitive Behavioral Group Therapy for Mood Management in Individuals with Intellectual Disabilities: A Pilot Study

    Science.gov (United States)

    Ghafoori, Bita; Ratanasiripong, Paul; Holladay, Christina

    2010-01-01

    Individuals with intellectual disabilities (ID) often display mental health symptoms that may benefit from psychotherapy. In this pilot study, a newly designed cognitive behavioral therapy (CBT) group treatment targeting mood difficulties was provided to 8 adults with mild-borderline ID. Assessment occurred at pretreatment, posttreatment, and 4…

  12. AAC Modeling with the iPad during Shared Storybook Reading Pilot Study

    Science.gov (United States)

    Sennott, Samuel C.; Mason, Linda H.

    2016-01-01

    This pilot study describes an intervention package, MODELER for Read and Talk, designed to provide enriched language interaction for children with complex communication needs who require augmentative and alternative communication (AAC). MODELER (Model, Encourage, Respond) includes (a) modeling AAC as you speak, (b) encouraging communication…

  13. Mood Management Intervention for College Smokers with Elevated Depressive Symptoms: A Pilot Study

    Science.gov (United States)

    Schleicher, Holly E.; Harris, Kari Jo; Campbell, Duncan G.; Harrar, Solomon W.

    2012-01-01

    Objective: This pilot study examined smoking reduction and cessation among college smokers with elevated depressive symptomatology participating in a group-based behavioral counseling, mood management, and motivational enhancement combined intervention (CBT). Participants and Methods: Fifty-eight smokers (smoked 6 days in the past 30) were…

  14. Etanercept in the treatment of patients with primary Sjogren's syndrome: a pilot study.

    NARCIS (Netherlands)

    Zandbelt, M.; Wilde, P.C.M. de; Damme, P.A. van; Hoyng, C.B.; Putte, L.B.A. van de; Hoogen, F.H.J. van den

    2004-01-01

    OBJECTIVE: This pilot study evaluated the effect of anti-tumor necrosis factor-a antiinflammatory treatment with etanercept (Enbrel(R)) on sicca, systemic, and histological signs in patients with primary Sjogren's syndrome (SS). METHODS: Fifteen patients with well defined primary SS were treated wit

  15. A Pilot Study of a Kindergarten Summer School Reading Program in High-Poverty Urban Schools

    Science.gov (United States)

    Denton, Carolyn A.; Solari, Emily J.; Ciancio, Dennis J.; Hecht, Steven A.; Swank, Paul R.

    2010-01-01

    This pilot study examined an implementation of a kindergarten summer school reading program in 4 high-poverty urban schools. The program targeted both basic reading skills and oral language development. Students were randomly assigned to a treatment group (n = 25) or a typical practice comparison group (n = 28) within each school; however,…

  16. Effects of Group Therapy on Female Adolescent Survivors of Sexual Abuse: A Pilot Study.

    Science.gov (United States)

    Thun, Debra; Sims, Patricia L.; Adams, Mary Ann; Webb, Thomas

    2002-01-01

    Explores treatment interventions for female sexual abuse survivors through a pilot study examining the relationship between group treatment and adolescent self-image. Results revealed that participants who received group therapy increased in levels of impulse control and that the experimental group had a decrease in self-reliance whereas the…

  17. Increasing Physical Activity in Preschool: A Pilot Study to Evaluate Animal Trackers

    Science.gov (United States)

    Williams, Christine L.; Carter, Betty Jean; Kibbe, Debra L.; Dennison, David

    2009-01-01

    Objective: This report describes a pilot study to evaluate Animal Trackers (AT), a preschool program designed to (1) increase structured physical activity (PA) during the preschool day; (2) increase practice of gross motor skills; (3) provide teachers with an easy-to-use PA program regardless of teacher experience; and (4) implement a teacher…

  18. A systematic approach for designing a HBM Pilot Study for Europe

    DEFF Research Database (Denmark)

    Becker, Kerstin; Seiwert, Margarete; Casteleyn, Ludwine

    2014-01-01

    The objective of COPHES (Consortium to Perform Human biomonitoring on a European Scale) was to develop a harmonised approach to conduct human biomonitoring on a European scale. COPHES developed a systematic approach for designing and conducting a pilot study for an EU-wide cross-sectional human b...

  19. The Impact of Blog-Style Writing on Student Learning Outcomes: A Pilot Study

    Science.gov (United States)

    Hansen, Holley E.

    2016-01-01

    Two major goals of teaching include educating students to communicate effectively and encouraging students to critically engage with information. To what extent can student blog writing help us achieve these goals? In this pilot study, I analyze how short "blog-style" writing assignments compare to more traditional short research essays…

  20. Do Children with down Syndrome Perform Sufficient Physical Activity to Maintain Good Health? A Pilot Study

    Science.gov (United States)

    Shields, Nora; Dodd, Karen J.; Abblitt, Casey

    2009-01-01

    Our pilot study investigated if children with Down syndrome engaged in the recommended 60 min of moderate to vigorous physical activity (MVPA) every day. Twenty-three children with Down syndrome (7 girls, 16 boys; mean age 11.7 years, SD = 3.1) wore a triaxial accelerometer for 7 consecutive days to measure their activity levels. The average…

  1. Analysis of Physical Therapy Goals in a School-Based Setting: A Pilot Study

    Science.gov (United States)

    McConlogue, Agnes; Quinn, Lori

    2009-01-01

    The purpose of this pilot study was to analyze physical therapy goals for students receiving services in the school setting and to determine if these goals are measurable and context specific. The Individualized Education Program (IEP) of 32 students receiving physical therapy services was analyzed to determine the type of task and context that…

  2. Behavioral Activation Treatment for Depression in Older Adults Delivered via Videoconferencing: A Pilot Study

    Science.gov (United States)

    Lazzari, Claudia; Egan, Sarah J.; Rees, Clare S.

    2011-01-01

    Depression affects up to 25% of older adults. Underdetection and subsequent undertreatment of depression in older adults has been attributed in part to difficulties in older adults being able to access treatment. This uncontrolled pilot study, N = 3, explored the acceptability and efficacy of a brief behavioral activation treatment delivered via…

  3. Information Anxiety from the Undergraduate Student Perspective: A Pilot Study of Second-Semester Freshmen

    Science.gov (United States)

    Blundell, Shelley; Lambert, Frank

    2014-01-01

    In early spring 2013, a pilot study was conducted at a major public university in Ohio to explore elements of information anxiety (defined herein as a combination of library anxiety and information technology anxiety) among second-semester freshmen enrolled in all iterations of both a traditional and a remedial first-year English course. The…

  4. Practical and Scholarly Implications of Information Behaviour Research: A Pilot Study of Research Literature

    Science.gov (United States)

    Koh, Kyungwon; Rubenstein, Ellen; White, Kelvin

    2015-01-01

    Introduction: This pilot study examined how current information behaviour research addresses the implications and potential impacts of its findings. The goal was to understand what implications and contributions the field has made and how effectively authors communicate implications of their findings. Methods: We conducted a content analysis of 30…

  5. Private Giving to Public Schools and Districts in Los Angeles County: A Pilot Study.

    Science.gov (United States)

    Zimmer, Ron; Krop, Cathy; Kaganoff, Tessa; Ross, Karen E.; Brewer, Dominic J.

    In an era of dependence on nonflexible funding by states, private support is a desirable source of funding. Anecdotal reports and a limited body of documented research suggest districts and schools are pursuing private support with increased sophistication and aggressiveness. This pilot study is designed to provide schools and school districts…

  6. Improving the School Food Environment: Results from a Pilot Study in Middle Schools

    Science.gov (United States)

    Our objective for this study was to examine the feasibility of instituting environmental changes during a 6-week pilot in school food service programs, with long-term goals of improving dietary quality and preventing obesity and type 2 diabetes in youth. Participants included students and staff from...

  7. NATO CCMS PILOT STUDY ON CLEAN PRODUCTS AND PROCESSES -(PHASE I) - 2002 ANNUAL REPORT

    Science.gov (United States)

    The annual report summarizes the activities of the NATO CCMS Pilot Study on clean products and processes for 2002, including the proceedings of the 2002 annual meeting held in Vilnius, Lithuania. The report presents a wealth of information on cleaner production activities in ove...

  8. NATO/CCMS PILOT STUDY - CLEAN PRODUCTS AND PROCESSES (PHASE I) 2000 ANNUAL REPORT, NUMBER 242

    Science.gov (United States)

    This annual report presents the proceedings of the Third Annual NATO/CCMS pilot study meeting in Copenhagen, Denmark. Guest speakers focused on efforts in the area of research of clean products and processes, life cycle analysis, computer tools and pollution prevention.

  9. Excessive Use of Massively Multi-Player Online Role-Playing Games: A Pilot Study

    Science.gov (United States)

    Hussain, Zaheer; Griffiths, Mark D.

    2009-01-01

    Massively multiplayer online role-playing games (MMORPGs) are one of the most interesting innovations in the area of online computer gaming. This pilot study set out to examine the psychological and social effects of online gaming using an online questionnaire with particular reference to excessive and "dependent" online gaming. A self-selecting…

  10. Acute low back pain is marked by variability: An internet-based pilot study

    Directory of Open Access Journals (Sweden)

    Katz Jeffrey N

    2011-10-01

    Full Text Available Abstract Background Pain variability in acute LBP has received limited study. The objectives of this pilot study were to characterize fluctuations in pain during acute LBP, to determine whether self-reported 'flares' of pain represent discrete periods of increased pain intensity, and to examine whether the frequency of flares was associated with back-related disability outcomes. Methods We conducted a cohort study of acute LBP patients utilizing frequent serial assessments and Internet-based data collection. Adults with acute LBP (lasting ≤3 months completed questionnaires at the time of seeking care, and at both 3-day and 1-week intervals, for 6 weeks. Back pain was measured using a numerical pain rating scale (NPRS, and disability was measured using the Oswestry Disability Index (ODI. A pain flare was defined as 'a period of increased pain lasting at least 2 hours, when your pain intensity is distinctly worse than it has been recently'. We used mixed-effects linear regression to model longitudinal changes in pain intensity, and multivariate linear regression to model associations between flare frequency and disability outcomes. Results 42 of 47 participants (89% reported pain flares, and the average number of discrete flare periods per patient was 3.5 over 6 weeks of follow-up. More than half of flares were less than 4 hours in duration, and about 75% of flares were less than one day in duration. A model with a quadratic trend for time best characterized improvements in pain. Pain decreased rapidly during the first 14 days after seeking care, and leveled off after about 28 days. Patients who reported a pain flare experienced an almost 3-point greater current NPRS than those not reporting a flare (mean difference [SD] 2.70 [0.11]; p ß [SE} 0.28 (0.08; p = 0.002. Conclusions Acute LBP is characterized by variability. Patients with acute LBP report multiple distinct flares of pain, which correspond to discrete increases in pain intensity. A

  11. The effect of comorbidities on COPD assessment: a pilot study

    Directory of Open Access Journals (Sweden)

    Weinreich UM

    2015-02-01

    Full Text Available Ulla Møller Weinreich,1–3 Lars Pilegaard Thomsen,2 Barbara Bielaska,4 Vania Helbo Jensen,5,6 Morten Vuust,4 Stephen Edward Rees2 1Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; 2Respiratory and Critical Care Group (RCARE, Centre for Model-Based Medical Decision Support Systems, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; 3The Clinical Institute, Aalborg University Hospital, Aalborg, Denmark; 4Department of Radiology, Vendsyssel Hospital, Hjørring, Denmark; 5Department of Radiology, Horsens Regional Hospital, Horsens, Denmark; 6Department of Radiology, Aalborg University Hospital, Aalborg, Denmark Introduction: Patients with chronic obstructive pulmonary disease (COPD frequently suffer from comorbidities. COPD severity may be evaluated by the Global initiative for chronic ­Obstructive Lung Disease (GOLD combined risk assessment score (GOLD score. Spirometry, body plethysmography, diffusing capacity of the lung for carbon monoxide (DLCO, and high-resolution computed tomography (HR-CT measure lung function and elucidate pulmonary pathology. This study assesses associations between GOLD score and measurements of lung function in COPD patients with and without (≤1 comorbidities. It evaluates whether the presence of comorbidities influences evaluation by GOLD score of COPD severity, and questions whether GOLD score describes morbidity rather than COPD severity.Methods: In this prospective study, 106 patients with stable COPD were included. Patients treated for lung cancer were excluded. Demographics, oxygen saturation (SpO2, modified Medical Research Council Dyspnea Scale, COPD exacerbations, and comorbidities were recorded. Body plethysmography and DLCO were measured, and HR-CT performed and evaluated for emphysema and airways disease. COPD severity was stratified by the GOLD score. Correlation analyses: 1 GOLD score, 2 emphysema grade, and 3 airways disease and lung

  12. Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study

    Directory of Open Access Journals (Sweden)

    Sword Wendy

    2012-04-01

    Full Text Available Abstract Background Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. Methods A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework. Results The three main categories informed by Donabedian's model of quality health care were structure of care, clinical care processes, and interpersonal care processes. Structure of care themes included access, physical setting, and staff and care provider characteristics. Themes under clinical care processes were health promotion and illness prevention, screening and assessment, information sharing, continuity of care, non-medicalization of pregnancy, and women-centredness. Interpersonal care processes themes were respectful attitude, emotional support, approachable interaction style, and taking time. A recurrent theme woven throughout the data reflected the importance of a meaningful relationship between a woman and her prenatal care provider that was characterized by trust. Conclusions While certain aspects of structure of care were identified as being key dimensions of

  13. Intravenous thrombolytic therapy for acute ischemic stroke (A pilot study in China)

    Institute of Scientific and Technical Information of China (English)

    Qingtang CHEN, MD

    2000-01-01

    Objective: This paper is the results of an open clinical trial, and also a pilot study of a 5-year National Project “Clinical study of thrombolytic therapy for iscbemic stroke within 6 hours of onset” (19962000). The purpose of this pilot study is to evaluate the efficacy and safety of intravenously administered thrombolytic therapy for isehemic stroke (mostly within 6 hours and partly within 12 hours of onset), using urokinase, produced by Tian Pu Pharmaceutical Company, China. The second phase of this clinical trial, a multicenter, randomized, double blind, placebo-controlled study will be finished by the end of the year 2000. Patients and Methods: The inclusion criteria of this study included 1. The age was between 35 and 80. 2. The time window should be controlled within 6 hours from the onset. If it was an evolved stroke, the consciousness of the patient was clear or only mild drowsy, and the CT scan didn't show any low density area, the time window could be controlled within 12 houri. 3. The clinical features indicated a carotid territory stroke. 4. CT scan demonstrated no intracranial bleeding or low density area, not including the old lacunes not related to this stroke. 5. The blood pressure should be controlled under 180/100 mmHg. 6 The consciousness of the patient should be clear, or mild drowsy. 7. The severity of the paralytic limbs was between 0 and 3 degrees (with a scale of 0~5degree). 8. An informed consent was required. The patients were assigned to receive the treatment with urokinase (UK) 1.0-l.5million U given over 30 minutes. After UK infusion, 500 ml of low molecular weight dextran will be continued daily for l0 days. 24h after UK infusion, 300 mg aspirin daily will be administered for 10days, andthen l00mgof aspirin daily for 80 days. The neurological deficit was measured by European Stroke Scale (ESS) and was recorded before therapy and at 2h, ld, 3d, 7d, 14d, 30d, and 90d after therapy. Results: The results revealed that 409 cases

  14. Clinical Holistic Medicine: Pilot Study on the Effect of Vaginal Acupressure (Hippocratic Pelvic Massage

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2006-01-01

    Full Text Available This is a pilot study of 20 female patients with a long history of sexual problems (mean is 8.92 years who received vaginal acupressure (VA with a quantitative and qualitative evaluation: 56% experienced help and none reported setbacks, 89% rated the treatment to be of high quality, and 89% rated it as valuable. After the treatment, most reported their problems to be less serious and their general quality of life improved. Only 17% reported minor or temporary side effects. VA was found statistically and clinically significant (p < 0.05, improvement more than 0.5 step on a 5-point Likert scale to help patients with chronic genital pains, pain or discomfort during sexual intercourse, lack of desire or orgasm, and subjective sexual insufficiency, and all patients taken as one group (about 1 step up a 5-point Likert scale. Self-evaluated physical and mental health was significantly improved for the total group; the relationship with partner, the subjective sexual ability, and the quality of life that were measured with QOL1 and QOL5 questionnaires were all significantly improved. VA or Hippocratic pelvic massage is technically a simple procedure corresponding to the explorative phase of the standard pelvic examination, supplemented with the patient’s report on the feelings provoked followed by processing and integration of these feelings, but ethical aspects are complicated. Acupressure through the vagina/pelvic massage must be done according to the highest ethical standard with great care, after obtaining consent and the necessary trust of the patient within the framework of the local laws. It must be followed by conversational therapy and further holistic existential processing.

  15. Autologous bone marrow-derived stem cells in amyotrophic lateral sclerosis: A pilot study

    Directory of Open Access Journals (Sweden)

    Sudesh Prabhakar

    2012-01-01

    Full Text Available Background: Amyotrophic lateral sclerosis (ALS is a neurodegenerative disorder with no effective treatment. Stem cell therapy may be one of the promising treatment options for such patients. Aim: To assess the feasibility, efficacy and safety of autologous bone marrow-derived stem cells in patients of ALS. Settings and Design: We conducted an open-label pilot study of autologous bone marrow-derived stem cells in patients with ALS attending the Neurology Clinic of a tertiary care referral centre. Materials and Methods: Ten patients with ALS with mean revised ALS Functional Rating Scale (ALSFRS-R score of 30.2 (± 10.58 at baseline received intrathecal autologous bone marrow-derived stem cells. Primary end point was improvement in the ALSFRS-R score at 90, 180, 270 and 365 days post therapy. Secondary endpoints included ALSFRS-R subscores, time to 4-point deterioration, median survival and reported adverse events. Paired t-test was used to compare changes in ALSFRS-R from baseline and Kaplan-Meier analysis was used for survival calculations. Results: There was no significant deterioration in ALSFRS-R composite score from baseline at one-year follow-up (P=0.090. The median survival post procedure was 18.0 months and median time to 4-point deterioration was 16.7 months. No significant adverse events were reported. Conclusion: Autologous bone marrow-derived stem cell therapy is safe and feasible in patients of ALS. Short-term follow-up of ALSFRS-R scores suggests a trend towards stabilization of disease. However, the benefit needs to be confirmed in the long-term follow-up period.

  16. Study of the thermal decomposition of petrochemical sludge in a pilot plant reactor

    OpenAIRE

    Conesa Ferrer, Juan Antonio; Moltó Berenguer, Julia; Ariza, José; Ariza, María; García Barneto, Agustín

    2014-01-01

    The pyrolysis of a sludge produced in the waste water treatment plant of an oil refinery was studied in a pilot plant reactor provided with a system for condensation of semivolatile matter. The study comprises experiments at 350, 400, 470 and 530 °C in nitrogen atmosphere. Analysis of all the products obtained (gases, liquids and chars) are presented, with a thermogravimetric study of the char produced and analysis of main components of the liquid. In the temperature range studied, the compos...

  17. Final Report of NATO/SPS Pilot Study on Clean Products and Processes (Phase I and II)

    Science.gov (United States)

    Early in 1998 the NATO Committee for Challenges to Modern Society (SPS) (Science for Peace and Security) approved the Pilot Study on Clean Products and Processes for an initial period of five years. The pilot was to provide a forum for member country representatives to discuss t...

  18. Strengthening Interprofessional Requirements Engineering Through Action Sheets: A Pilot Study

    Science.gov (United States)

    Pohlmann, Sabrina; Heinze, Oliver; Brandner, Antje; Reiß, Christina; Kamradt, Martina; Szecsenyi, Joachim; Ose, Dominik

    2016-01-01

    Background The importance of information and communication technology for healthcare is steadily growing. Newly developed tools are addressing different user groups: physicians, other health care professionals, social workers, patients, and family members. Since often many different actors with different expertise and perspectives are involved in the development process it can be a challenge to integrate the user-reported requirements of those heterogeneous user groups. Nevertheless, the understanding and consideration of user requirements is the prerequisite of building a feasible technical solution. In the course of the presented project it proved to be difficult to gain clear action steps and priorities for the development process out of the primary requirements compilation. Even if a regular exchange between involved teams took place there was a lack of a common language. Objective The objective of this paper is to show how the already existing requirements catalog was subdivided into specific, prioritized, and coherent working packages and the cooperation of multiple interprofessional teams within one development project was reorganized at the same time. In the case presented, the manner of cooperation was reorganized and a new instrument called an Action Sheet was implemented. This paper introduces the newly developed methodology which was meant to smooth the development of a user-centered software product and to restructure interprofessional cooperation. Methods There were 10 focus groups in which views of patients with colorectal cancer, physicians, and other health care professionals were collected in order to create a requirements catalog for developing a personal electronic health record. Data were audio- and videotaped, transcribed verbatim, and thematically analyzed. Afterwards, the requirements catalog was reorganized in the form of Action Sheets which supported the interprofessional cooperation referring to the development process of a personal

  19. Existing Whole-House Solutions Case Study: Greenbelt Homes, Inc. Pilot Retrofit Project

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-06-01

    In the fall of 2010, a multiyear pilot energy efficiency retrofit project was undertaken by Greenbelt Homes, Inc., (GHI) a 1,566 home cooperative of circa 1930 and 1940 homes in Greenbelt, Maryland. GHI established this pilot project to serve as a basis for decision making for the rollout of a community-wide upgrade program that will incorporate energy efficiency improvements to the building envelope and mechanical equipment. With the community upgrade fully funded by the cooperative through their membership without outside subsidies, this project presents a unique opportunity to evaluate and prioritize the wide range of benefits of high-performance retrofits based on member experience with and acceptance of the retrofit measures implemented during the pilot project. Addressing the complex interactions between benefits, trade-offs, construction methods, project management implications, realistic upfront costs, financing, and other considerations, serves as a case study for energy retrofit projects that include high-performance technologies based on the long-term value to the homeowner. The pilot project focused on identifying the added costs and energy-savings benefits of improvements. Phase 1—baseline evaluation for a representative set of 28 homes sited in seven buildings; Phase 2—installation of the building envelope improvements and continued monitoring of the energy consumption for the heating season; Phase 3—energy simulations supporting recommendations for HVAC and water heating upgrades.

  20. Using electronic medical records to determine prevalence and treatment of mental disorders in primary care: a database study

    OpenAIRE

    Gleeson, M; Hannigan, Ailish; Jamali, R; Su Lin, K; Klimas, Jan; Mannix, M; Nathan, Yoga; O'Connor, R; O'Gorman, Clodagh S.; Dunne, Colum; Meagher, David; Cullen, Walter

    2015-01-01

    peer-reviewed Objectives: With prevention and treatment of mental disorders a challenge for primary care and increasing capability of electronic medical records (EMRs) to facilitate research in practice, we aim to determine the prevalence and treatment of mental disorders by using routinely collected clinical data contained in EMRs. Methods: We reviewed EMRs of patients randomly sampled from seven general practices, by piloting a study instrument and extracting data on menta...